Individual
AMANDA GRACE FENTRESS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3098 CORTONA DR, MELBOURNE, FL 32940-8609
(321) 544-4079
Mailing address
3098 CORTONA DR, MELBOURNE, FL 32940-8609
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1237720
FL
Other
Enumeration date
11/19/2025
Last updated
11/19/2025
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