MEDICARE: DR. AMANDA R. J. BROOME DC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	DCP00687	RI
2	111N00000X	Chiropractor	CH15414	FL

General Provider Information

NPI Number	:	1205413697
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. AMANDA R. J. BROOME DC

Provider Business Mailing Address
First Line	:	1558 NE 162ND ST STE A
Second Line	:
City	:	NORTH MIAMI BEACH
State	:	FL
Zip	:	33162-4716
Country	:	US
Telephone Number	:	786-245-7444
Fax Number	:	786-863-8005

Provider Business Practice Location Address
First Line	:	1558 NE 162ND ST STE A
Second Line	:
City	:	NORTH MIAMI BEACH
State	:	FL
Zip	:	33162-4716
Country	:	US
Telephone Number	:	786-245-7444
Fax Number	:	786-863-8005

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/24/2021
Last Update Date	:	03/21/2025

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