Individual
AMANDA ROEDING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
9320 STATE ROAD 54, TRINITY, FL 34655-1808
(727) 493-2513
Mailing address
PO BOX 102222, ATLANTA, GA 30368-2222
(727) 493-2513
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
APRN9308604
FL
363LF0000X
Family Nurse Practitioner
9308604
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
254016982
—
FL
Enumeration date
09/15/2014
Last updated
10/27/2022
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