Provider Demographics
NPI:1164314860
Name:FERRAGAMO, AMANDA SUZANNE (RD)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:SUZANNE
Last Name:FERRAGAMO
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:36807 WOODS DR
Mailing Address - Street 2:
Mailing Address - City:FRUITLAND PARK
Mailing Address - State:FL
Mailing Address - Zip Code:34731-5002
Mailing Address - Country:US
Mailing Address - Phone:954-826-2612
Mailing Address - Fax:
Practice Address - Street 1:36807 WOODS DR
Practice Address - Street 2:
Practice Address - City:FRUITLAND PARK
Practice Address - State:FL
Practice Address - Zip Code:34731-5002
Practice Address - Country:US
Practice Address - Phone:954-826-2612
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-17
Last Update Date:2025-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLND6381133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered