Healthcare Provider Details

I. General information

NPI: 1053030650
Provider Name (Legal Business Name): AMANDA MARGARET BRZEZINSKI DNP, APRN, CPNP-AC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/25/2022
Last Update Date: 10/28/2024
Certification Date: 10/28/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2502 W SAINT ISABEL ST
TAMPA FL
33607-6318
US

IV. Provider business mailing address

2502 W SAINT ISABEL ST
TAMPA FL
33607-6318
US

V. Phone/Fax

Practice location:
  • Phone: 813-874-5707
  • Fax:
Mailing address:
  • Phone: 813-874-5707
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberAPRN11021493
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code163WP0200X
TaxonomyPediatric Registered Nurse
License Number9398587
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: