Individual
MRS. AMANDA ANN FOLKERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2222 S HARBOR CITY BLVD, SUITE 610, MELBOURNE, FL 32901-5594
(321) 723-7716
(321) 723-0604
Mailing address
2222 S HARBOR CITY BLVD STE 610, MELBOURNE, FL 32901-5591
(321) 723-7716
(321) 723-0604
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA9106788
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
022288200
—
FL
01
—
OV558
MEDICARE HF
FL
01
—
Y0H0V
FLORIDA BLUE
FL
Enumeration date
10/30/2012
Last updated
01/28/2022
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