Basic Information
Provider Information
NPI: 1982074860
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: AMATO
FirstName: BRITTANY
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: AGACNP-BC
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2900 CORPORATE WAY
Address2: DOOR D
City: MIRAMAR
State: FL
PostalCode: 330253925
CountryCode: US
TelephoneNumber: 9542765685
FaxNumber: 9549857074
Practice Location
Address1: 3501 JOHNSON ST
Address2: 3RD FLOOR
City: HOLLYWOOD
State: FL
PostalCode: 330215421
CountryCode: US
TelephoneNumber: 9542659976
FaxNumber: 9549655396
Other Information
ProviderEnumerationDate: 10/05/2015
LastUpdateDate: 11/18/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 11/18/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LA2100XARNP9264386FLY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care

ID Information
IDTypeStateIssuerDescription
198207486005NC MEDICAID
NP348005SC MEDICAID


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