Individual provider Active NPI

Amanda Vetra, APRN

  • Family Nurse Practitioner
  • Gulf Breeze, FL
National Provider Identifier
1316702129
Registry record updated Aug 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN11031374 Issued in FL
Practice address
3363 La Condesa St
Gulf Breeze, FL 32563-2748
Phone
(850) 525-7050
NPI assigned
Feb 20, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APRN11031374 FL Primary

Addresses

Primary practice location

3363 La Condesa St
Gulf Breeze, FL 32563-2748

Mailing address

3363 La Condesa St
Gulf Breeze, FL 32563-2748

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251125001216 FL Practitioner - Nurse Practitioner 1456892538 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
May accept Medicare assignment
Group practices
Vitas Solutions IncGroup PAC ID 7012087166, 55 clinicians

Practice addresses (Care Compare)

1230 Creighton Rd
Pensacola, FL 32504-7161
Phone (877) 868-4827

Hospital & facility affiliations

  • Sacred Heart Hospital Hospital, Pensacola, FL, CCN 100025

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
APRN11031374FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Vitas Solutions Inc CurrentSince Sep 15, 2025 Accepting new patients

Locations

601 E Rollins St
Orlando, FL 32803
Phone (407) 303-1996

1230 Creighton Rd
Pensacola, FL 32504
Phone (850) 477-5586

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1708387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723680000000",
    "number": "1316702129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3363 LA CONDESA ST",
            "city": "GULF BREEZE",
            "state": "FL",
            "postal_code": "325632748"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3363 LA CONDESA ST",
            "city": "GULF BREEZE",
            "state": "FL",
            "postal_code": "325632748",
            "telephone_number": "850-525-7050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VETRA",
        "first_name": "AMANDA",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-02-20",
        "last_updated": "2024-08-15",
        "certification_date": "2024-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11031374",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gulf Breeze, FL

Sources for this page

Verify at the official NPI Registry.