Individual
AMANDA PERSAUD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2 TAMPA GENERAL CIR STE 740, TAMPA, FL 33606-3571
(813) 821-8038
Mailing address
PO BOX 917770, ORLANDO, FL 32891-0001
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA9112348
FL
363A00000X
Physician Assistant
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
105899900
—
FL
01
—
G9W6I
BCBS
FL
01
—
PA9112348
FLORIDA LICENCE
FL
Enumeration date
05/08/2019
Last updated
11/15/2022
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