Individual
AMANDA C TROUT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
954 AVENIDA PONCE DE LEON, STE 205- PMB#10600, SAN JUAN, PR 00906
(847) 275-5961
Mailing address
954 AVENIDA PONCE DE LEON, STE 205- PMB#10600, SAN JUAN, PR 00906
(847) 275-5961
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
Q7802
TX
208VP0014X
Interventional Pain Medicine Physician
Primary
Q7802
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
363846202
—
TX
Enumeration date
03/28/2011
Last updated
10/02/2023
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