Peck, Amanda Diane
Peck, Amanda Diane is an sole proprietor health care provider with primary practice located at 3573 Sw Corporate Pkwy , Palm City FL 34990-8153. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Peck, Amanda Diane can be contacted via phone (772) 283-5431.Contact Information
Primary practice address
3573 Sw Corporate Pkwy
Palm City FL 34990-8153
Phone: (772) 283-5431
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | ME89635 | Florida |
Profile Details
| NPI number | 1215956750 |
|---|---|
| LBN Legal business name | Peck, Amanda Diane |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jul 18th, 2006 |
| Last updated | Dec 20th, 2012 - about 13 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1215956750 | NPPES |
| Florida | MEDICAID | 377282901 |
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