Active NPI
Amanda Fernandez
- Clinical Social Worker
- Tampa, FL
National Provider Identifier
1780207696
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- SW17117
- Practice address
- 6421 N Florida Ave Ste D-1605
Tampa, FL 33604-6007 - Phone
- (813) 474-8567
- NPI assigned
- May 26, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | SW17117 | FL | Primary |
Addresses
Primary practice location
6421 N Florida Ave Ste D-1605
Tampa, FL 33604-6007
Mailing address
6421 N Florida Ave Ste D-1605
Tampa, FL 33604-6007
Phone (904) 717-1618
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SW17117 | FL | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1590451200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1738195200000",
"number": "1780207696",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6421 N FLORIDA AVE STE D-1605",
"city": "TAMPA",
"state": "FL",
"postal_code": "336046007",
"telephone_number": "904-717-1618"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6421 N FLORIDA AVE STE D-1605",
"city": "TAMPA",
"state": "FL",
"postal_code": "336046007",
"telephone_number": "813-474-8567"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FERNANDEZ",
"first_name": "AMANDA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-05-26",
"last_updated": "2025-01-30",
"certification_date": "2025-01-30",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "FL",
"license": "SW17117",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tampa, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.