MEDICARE: AMANDA KWASNICKI MD

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	207T00000X	Neurological Surgery Physician	036.145941	IL
2	207T00000X	Neurological Surgery Physician	ME163703	FL

General Provider Information

NPI Number	:	1942695135
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMANDA KWASNICKI MD

Provider Business Mailing Address
First Line	:	1150 N 35TH AVE STE 520
Second Line	:
City	:	HOLLYWOOD
State	:	FL
Zip	:	33021-5431
Country	:	US
Telephone Number	:	954-265-3500
Fax Number	:

Provider Business Practice Location Address
First Line	:	1150 N 35TH AVE STE 520
Second Line	:
City	:	HOLLYWOOD
State	:	FL
Zip	:	33021-5431
Country	:	US
Telephone Number	:	954-265-3500
Fax Number	:

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

Provider Enumeration Date	:	04/03/2015
Last Update Date	:	03/13/2026

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Directions to “ AMANDA KWASNICKI MD” Practice Location

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