Provider Demographics
NPI:1588064513
Name:VELARDE, AMANDA NICHOLE (PHARMD)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:NICHOLE
Last Name:VELARDE
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12547 23RD ST E
Mailing Address - Street 2:
Mailing Address - City:PARRISH
Mailing Address - State:FL
Mailing Address - Zip Code:34219-6907
Mailing Address - Country:US
Mailing Address - Phone:904-236-1254
Mailing Address - Fax:
Practice Address - Street 1:3913 MANATEE AVE W
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34205-1715
Practice Address - Country:US
Practice Address - Phone:941-746-5633
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-27
Last Update Date:2021-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS52474183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist