Provider Demographics
NPI:1215299540
Name:KANE, AMANDA MARIE (MD)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:MARIE
Last Name:KANE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:329 NOKOMIS AVE S STE H
Mailing Address - Street 2:
Mailing Address - City:VENICE
Mailing Address - State:FL
Mailing Address - Zip Code:34285-2418
Mailing Address - Country:US
Mailing Address - Phone:941-499-1301
Mailing Address - Fax:941-499-1305
Practice Address - Street 1:2665 STATE ROAD 580 # 580
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33761-3166
Practice Address - Country:US
Practice Address - Phone:724-981-8070
Practice Address - Fax:724-704-7418
Is Sole Proprietor?:No
Enumeration Date:2012-06-12
Last Update Date:2020-12-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD458992207V00000X
FLME128523207V00000X
FLTRN17215207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology