Individual
AMANDA MICHELLE WHITE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
938 GEARY ST SW, PALM BAY, FL 32908-4206
(740) 405-8828
Mailing address
938 GEARY ST SW, PALM BAY, FL 32908-4206
(740) 405-8828
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
—
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
105624800
—
FL
Enumeration date
06/19/2020
Last updated
06/19/2020
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