Amanda Rae Bock, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

AL5388 Issued in FL

Practice address

3301 College Ave
Davie, FL 33314-7721

Phone

(954) 262-8286

NPI assigned

Oct 17, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1539734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539734400000",
    "number": "1922574995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 NW 128TH DR APT 301",
            "city": "SUNRISE",
            "state": "FL",
            "postal_code": "333235202",
            "telephone_number": "661-645-6811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3301 COLLEGE AVE",
            "city": "DAVIE",
            "state": "FL",
            "postal_code": "333147721",
            "telephone_number": "954-262-8286"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOCK",
        "first_name": "AMANDA",
        "middle_name": "RAE",
        "name_prefix": "Miss",
        "credential": "ATC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-10-17",
        "last_updated": "2018-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "FL",
            "license": "AL5388",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Blue Hearts Medical Supplies Inc
• Barry Adam Bluth, DMD
• Sherri Jean Bluth, D.M.D.
• Marianna Larisa Blyumin-Karasik, M.D.
• Alexa Bock, APRN
• Suanne Boehm, PHARMD
• David Robert Boesler, D.O.
• Annette D. Bogle
• Thomas Anthony Bohan
• Christopher Boldrin, PTA, CSCS

• Athletic Trainer in Davie, FL
• Providers in Davie, FL by specialty
• Athletic Trainer in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.