Provider Demographics
NPI:1285094987
Name:WARE, AMENDHA (APRN)
Entity type:Individual
Prefix:
First Name:AMENDHA
Middle Name:
Last Name:WARE
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:AMENDHA
Other - Middle Name:
Other - Last Name:SAINT-DIC
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:400 CELEBRATION PL STE A290
Mailing Address - Street 2:
Mailing Address - City:CELEBRATION
Mailing Address - State:FL
Mailing Address - Zip Code:34747-4970
Mailing Address - Country:US
Mailing Address - Phone:407-303-3827
Mailing Address - Fax:407-303-3828
Practice Address - Street 1:400 CELEBRATION PL STE A290
Practice Address - Street 2:
Practice Address - City:CELEBRATION
Practice Address - State:FL
Practice Address - Zip Code:34747-4970
Practice Address - Country:US
Practice Address - Phone:407-303-3827
Practice Address - Fax:407-303-3828
Is Sole Proprietor?:No
Enumeration Date:2016-02-24
Last Update Date:2020-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN9336486363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily