Provider Demographics
NPI:1427859560
Name:GRONNIGER, AMANDA MARIE (PHARMD, CPH, BCCP)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:MARIE
Last Name:GRONNIGER
Suffix:
Gender:
Credentials:PHARMD, CPH, BCCP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7400 SW 87TH AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33173-5458
Mailing Address - Country:US
Mailing Address - Phone:786-662-7159
Mailing Address - Fax:
Practice Address - Street 1:7400 SW 87TH AVE STE 100
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33173-5458
Practice Address - Country:US
Practice Address - Phone:786-204-4499
Practice Address - Fax:786-591-6085
Is Sole Proprietor?:No
Enumeration Date:2025-03-24
Last Update Date:2025-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1-116335183500000X
MO2014029952183500000X
FLPU96161835C0206X
FLPS52329183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No1835C0206XPharmacy Service ProvidersPharmacistCardiology