Healthcare Provider Details

I. General information

NPI: 1659168136
Provider Name (Legal Business Name): AMANDA MARIA CUOMO MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/21/2025
Last Update Date: 04/21/2025
Certification Date: 04/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1713 6TH AVE S
BIRMINGHAM AL
35294-0001
US

IV. Provider business mailing address

13988 STONE HARBOUR DR
NORTHPORT AL
35475-3052
US

V. Phone/Fax

Practice location:
  • Phone: 205-934-6054
  • Fax:
Mailing address:
  • Phone: 205-544-1118
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number8679621
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: