Provider Demographics
NPI:1972098317
Name:FIJI, AMANDA JUSTINE (AGNP-BC)
Entity type:Individual
Prefix:MRS
First Name:AMANDA
Middle Name:JUSTINE
Last Name:FIJI
Suffix:
Gender:F
Credentials:AGNP-BC
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:8060 SPYGLASS HILL RD
Mailing Address - Street 2:
Mailing Address - City:VIERA
Mailing Address - State:FL
Mailing Address - Zip Code:32940-7983
Mailing Address - Country:US
Mailing Address - Phone:321-806-1874
Mailing Address - Fax:321-806-1875
Practice Address - Street 1:8060 SPYGLASS HILL RD
Practice Address - Street 2:
Practice Address - City:VIERA
Practice Address - State:FL
Practice Address - Zip Code:32940-7983
Practice Address - Country:US
Practice Address - Phone:321-806-1874
Practice Address - Fax:321-806-1875
Is Sole Proprietor?:No
Enumeration Date:2018-06-27
Last Update Date:2025-08-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FL9273003363LP2300X, 207RH0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative Medicine
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care