Healthcare Provider Details

I. General information

NPI: 1992630693
Provider Name (Legal Business Name): AMANDA MAGALYS PEREZ VIAMONTE OD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/15/2026
Last Update Date: 06/15/2026
Certification Date: 06/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17560 NW 27TH AVE STE 119
MIAMI GARDENS FL
33056-4075
US

IV. Provider business mailing address

17560 NW 27TH AVE STE 119
MIAMI GARDENS FL
33056-4075
US

V. Phone/Fax

Practice location:
  • Phone: 786-378-3445
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberOEG004377
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: