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1679115091
AMANDA NICOLE FORMELLA
JACKSONVILLE, FL
NPI
1679115091
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
163W00000X Registered Nurse
(Licence: FL RN9485994)
Enumeration Date
2019-10-17
Last Update Date
2019-10-17
Business Address
Mrs. AMANDA NICOLE FORMELLA RN
800 PRUDENTIAL DR
JACKSONVILLE, FL 32207-8211
Phone number: 352-502-3945
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Mailing Address
Mrs. AMANDA NICOLE FORMELLA RN
3848 AUTUMN LEAF CT
JACKSONVILLE, FL 32246-7674
Phone number: 352-502-3945
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