Individual
AMANDA STACHURA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
4729 N HABANA AVE, TAMPA, FL 33614-7113
(813) 251-8444
Mailing address
9204 HILLCROFT DR, RIVERVIEW, FL 33578-4742
(540) 838-5990
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
11004668
FL
Other
Enumeration date
02/06/2020
Last updated
10/02/2020
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