Provider Demographics
NPI:1932935988
Name:QUILICHINI ANTONI, AMANDA S (PHARM D)
Entity type:Individual
Prefix:DR
First Name:AMANDA
Middle Name:S
Last Name:QUILICHINI ANTONI
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4100 SW 64TH AVE UNIT 413
Mailing Address - Street 2:
Mailing Address - City:DAVIE
Mailing Address - State:FL
Mailing Address - Zip Code:33314-3656
Mailing Address - Country:US
Mailing Address - Phone:787-487-7180
Mailing Address - Fax:
Practice Address - Street 1:12500 W SUNRISE BLVD
Practice Address - Street 2:
Practice Address - City:SUNRISE
Practice Address - State:FL
Practice Address - Zip Code:33323-2987
Practice Address - Country:US
Practice Address - Phone:954-851-1006
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-09
Last Update Date:2024-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS67637183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist