Individual
AMANDA SURUJBALI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
2727 W DR MARTIN LUTHER KING JR BLVD STE 460, TAMPA, FL 33607-6001
(813) 879-4328
(813) 443-8152
Mailing address
2995 DREW ST, CLEARWATER, FL 33759-3012
(727) 315-7496
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
11034927
FL
363LG0600X
Gerontology Nurse Practitioner
Primary
APRN11034927
FL
Other
Enumeration date
08/22/2024
Last updated
03/10/2026
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