AMANDA LYNNE FAGAN

ORLANDO, FL
NPI1245617802
Former NameAMANDA LYNNE STUCK
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy207Q00000X Family Medicine
(Licence: FL  OS17191)
Additional Taxonomies207Q00000X Family Medicine
(Licence: NV  DO2319)
207Q00000X Family Medicine
(Licence: NV  SL1068)
Enumeration Date2015-05-04
Last Update Date2021-02-03
Business Address
AMANDA LYNNE FAGAN D.O
4613 S ORANGE BLOSSOM TRL
ORLANDO, FL 32839-1705
Phone number: 407-232-9833
Mailing Address
AMANDA LYNNE FAGAN D.O
4613 S ORANGE BLOSSOM TRL
ORLANDO, FL 32839-1705
Phone number: 407-232-9833