Fort, Amy J

Fort, Amy J is an individual health care provider with primary practice located at 1426 Longoak Dr S , Lakeland FL 33811-2115. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Fort, Amy J can be contacted via phone (863) 640-7013.

Contact Information

Primary practice address
1426 Longoak Dr S Lakeland FL 33811-2115
Phone: (863) 640-7013
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X ARNP9216870 Florida

Profile Details

NPI number 1326096264
LBN Legal business name Fort, Amy J
Credentials ARNP
Entity Individual
Sole proprietor 1 No
Enumeration date May 4th, 2006
Last updated Jun 1st, 2022 - about 4 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1326096264 NPPES
Florida MEDICAID 3074820-00
Florida Other DC8324

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