Individual
AMANDA J TRIMBLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
2 TAMPA GENERAL CIR, STC 2ND FLOOR, TAMPA, FL 33606-3603
(813) 396-9478
Mailing address
PO BOX 917770, ORLANDO, FL 32891-7770
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA9105068
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001397000
—
FL
01
—
Y00TZ
BLUE CROSS BLUE SHIELD
FL
Enumeration date
09/01/2009
Last updated
03/29/2011
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