Provider Demographics
NPI:1417732827
Name:BANDA, AMBER (DC)
Entity type:Individual
Prefix:
First Name:AMBER
Middle Name:
Last Name:BANDA
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3310 SW 35TH BLVD STE B
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32608-2407
Mailing Address - Country:US
Mailing Address - Phone:352-554-5346
Mailing Address - Fax:
Practice Address - Street 1:2701 SW COLLEGE RD STE 107
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34474-4436
Practice Address - Country:US
Practice Address - Phone:352-554-5346
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-25
Last Update Date:2024-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL14936111NN0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NN0400XChiropractic ProvidersChiropractorNeurology