Individual
AMANDA KIMBERLY ROSKEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1175 DUNLAWTON AVE STE 102, PORT ORANGE, FL 32127-4741
(386) 677-9044
Mailing address
1175 DUNLAWTON AVE STE 102, PORT ORANGE, FL 32127-4741
(386) 677-9044
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA9116725
FL
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
07/13/2022
Last updated
03/05/2023
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