Provider Demographics
NPI:1336595404
Name:DANLEY, AMANDA LILLIAN (MD)
Entity type:Individual
Prefix:DR
First Name:AMANDA
Middle Name:LILLIAN
Last Name:DANLEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MS
Other - First Name:AMANDA
Other - Middle Name:LILLIAN
Other - Last Name:GILBERTSEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:12730 NEW BRITTANY BLVD STE 602
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33907-4690
Mailing Address - Country:US
Mailing Address - Phone:239-275-5522
Mailing Address - Fax:239-275-4464
Practice Address - Street 1:1255 VISCAYA PKWY STE 200
Practice Address - Street 2:
Practice Address - City:CAPE CORAL
Practice Address - State:FL
Practice Address - Zip Code:33990-3290
Practice Address - Country:US
Practice Address - Phone:239-574-1988
Practice Address - Fax:239-574-1435
Is Sole Proprietor?:No
Enumeration Date:2016-05-09
Last Update Date:2020-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME139235207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine