Individual
MS. AMANDA MARILYN BRANCATO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2 TAMPA GENERAL CIR FL 3, TAMPA, FL 33606-3571
(813) 844-7585
Mailing address
PO BOX 917770, ORLANDO, FL 32891-0001
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA9113141
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
114018600
—
FL
01
—
PV673
BCBS
FL
Enumeration date
07/23/2017
Last updated
05/20/2022
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