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General NPI Number Information
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NPI Number | 1972098317
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Entity Type | Individual
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Provider Name | AMANDA JUSTINE FIJI AGNP-BC
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Gender | Female
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Dates
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Enumeration Date | 06/27/2018
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Last Update Date | 08/06/2025
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Provider Practice Location Address
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Address Line | 8060 SPYGLASS HILL RD
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City | VIERA
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State | FL
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Zip | 32940-7983
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Country | US
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Telephone | 321-806-1874
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Fax | 321-806-1875
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Provider Business Mailing Address
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Address Line | 8060 SPYGLASS HILL RD
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City | VIERA
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State | FL
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Zip | 32940-7983
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Country | US
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Telephone | 321-806-1874
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Fax | 321-806-1875
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number | 9273003
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 207RH0002X
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Taxonomy Name | Hospice and Palliative Medicine (Internal Medicine) Physician
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License Number | 9273003
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License Number State | FL
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