Individual provider · NPI-1

Amanda Jane Avila, MD

Psychiatry & Neurology, Neurology · Fort Myers, FL

NPI number1184841397
StatusActive
Last updated in NPPESJan 3, 2023

Details

NPI
1184841397
Entity type
Individual (NPI-1)
Name
Amanda Jane Avila
Credential
MD
Sex
Female
Sole proprietor
No
Enumeration date
Apr 19, 2007
Certification date
Jan 3, 2023
Last updated
Jan 3, 2023

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
2084N0400X Psychiatry & Neurology, NeurologyME112121FLYes
2084N0400X Psychiatry & Neurology, Neurology51225AZ
2084N0400X Psychiatry & Neurology, Neurology24413MS
2084N0400X Psychiatry & Neurology, Neurology292792NY
2084N0400X Psychiatry & Neurology, NeurologyTM00627TX
2084N0400X Psychiatry & Neurology, NeurologyMD60595494WA
2084N0400X Psychiatry & Neurology, Neurology4301114050MI
2084N0400X Psychiatry & Neurology, NeurologyMD171093OR
2084N0400X Psychiatry & Neurology, Neurology35.126796OH

Other names

  • Amanda Jane Thompson (Former Name)

Practice location

11215 Metro Pkwy Ste 1
Fort Myers, FL 33966-1206

Phone 239-208-2212

Mailing address

11215 Metro Pkwy Ste 1
Fort Myers, FL 33966-1206

Phone 239-208-2212 · Fax 239-208-3994

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