Provider Demographics
NPI:1275251308
Name:CLARKE, AMANDA N (PT,DPT)
Entity type:Individual
Prefix:DR
First Name:AMANDA
Middle Name:N
Last Name:CLARKE
Suffix:
Gender:F
Credentials:PT,DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3451 PINE RIDGE RD BLDG 601
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34109-3922
Mailing Address - Country:US
Mailing Address - Phone:394-493-0722
Mailing Address - Fax:877-334-1886
Practice Address - Street 1:1660 MEDICAL BLVD STE 200
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34110-1416
Practice Address - Country:US
Practice Address - Phone:239-566-3434
Practice Address - Fax:239-566-2143
Is Sole Proprietor?:No
Enumeration Date:2022-08-15
Last Update Date:2024-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT39240225100000X, 225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist