Provider Demographics
NPI:1720971302
Name:BERENGUER, AMANDA DE MOURA (PT)
Entity type:Individual
Prefix:MRS
First Name:AMANDA
Middle Name:DE MOURA
Last Name:BERENGUER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7463 VISCAYA CIR
Mailing Address - Street 2:
Mailing Address - City:MARGATE
Mailing Address - State:FL
Mailing Address - Zip Code:33063-6893
Mailing Address - Country:US
Mailing Address - Phone:754-249-0892
Mailing Address - Fax:
Practice Address - Street 1:4324 N FEDERAL HWY
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33308-5208
Practice Address - Country:US
Practice Address - Phone:954-369-5787
Practice Address - Fax:954-206-7733
Is Sole Proprietor?:No
Enumeration Date:2025-06-02
Last Update Date:2025-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT43182225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist