Individual
DR. AMY WINTERBOTHAM HARDMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2121 PARK ST, JACKSONVILLE, FL 32204-3811
(904) 387-6200
(904) 387-0261
Mailing address
2121 PARK ST, JACKSONVILLE, FL 32204-3811
(904) 387-6200
(904) 387-0261
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
ME76418
FL
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
ME 76418
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
259018200
—
FL
Enumeration date
08/23/2005
Last updated
02/13/2017
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