Individual
AMY M IANNELLO
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
PAC
Contact information
Practice address
1600 S ANDREWS AVE, ATRIUM BLDG 1ST FLOOR, FORT LAUDERDALE, FL 33316
(954) 760-7171
(954) 764-1722
Mailing address
PO BOX 862851, ORLANDO, FL 32886-2851
(954) 847-4273
(954) 847-4245
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA9101787
FL
Other
Enumeration date
04/20/2006
Last updated
07/08/2007
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