Individual
MS. AMY LYNAE VARNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
300 STATE ROAD 26, SUITE 200-3, MELROSE, FL 32666-3902
(352) 359-2412
Mailing address
PO BOX 357, MELROSE, FL 32666-0357
(352) 359-2412
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MA 42188
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C2784
BCBS PROVIDER NUMBER
FL
01
—
MA 42188
FL STATE LICENSE #
FL
Enumeration date
05/12/2007
Last updated
07/08/2007
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