Individual
AMANDA ROSE GLASS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9800 S HEALTHPARK DR STE 320, FORT MYERS, FL 33908-3630
(239) 343-6350
(239) 343-4738
Mailing address
PO BOX 2147, FORT MYERS, FL 33902-2147
(239) 343-6350
(239) 343-4738
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
APRN11025009
FL
363LA2200X
Adult Health Nurse Practitioner
Primary
APRN11025009
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
120416400
—
FL
Enumeration date
09/07/2023
Last updated
01/10/2024
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