Healthcare Provider Details

I. General information

NPI: 1134011794
Provider Name (Legal Business Name): AMBER NICOLE GERASIMCHIK AU.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/17/2025
Last Update Date: 07/25/2025
Certification Date: 07/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7135 NW 11TH PL
GAINESVILLE FL
32605-3159
US

IV. Provider business mailing address

2020 N 55TH AVE
HOLLYWOOD FL
33021-3940
US

V. Phone/Fax

Practice location:
  • Phone: 352-331-0090
  • Fax:
Mailing address:
  • Phone: 954-558-5614
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License NumberAY2945
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: