Active NPI
Amanda Davis, M.D.
- Pediatrics Physician
- Miami, FL
National Provider Identifier
1104278621
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- ME151594
- Practice address
- 5361 NW 22ND Ave
Miami, FL 33142-8035 - Phone
- (305) 637-6400
- NPI assigned
- Jul 8, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | MT211860 | PA | |
| Pediatrics Physician | 208000000X | ME151594 | FL | Primary |
Addresses
Primary practice location
5361 NW 22ND Ave
Miami, FL 33142-8035
Mailing address
5607 NW 27TH Ave Ste 1
Miami, FL 33142-2826
Phone (305) 805-1700
Other practice location 1
3401 Civic Center Blvd 9NW Rm 55
The Children's Hospital of Philadelphia
Philadelphia, PA 19104
Phone (215) 590-1220
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 111221200 | Medicaid | FL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20221213001274 | FL | Practitioner - Pediatric Medicine | 1052644176 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MT211860 | PA | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1467936000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1742860800000",
"number": "1104278621",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5607 NW 27TH AVE STE 1",
"city": "MIAMI",
"state": "FL",
"postal_code": "331422826",
"telephone_number": "305-805-1700",
"fax_number": "305-805-1715"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5361 NW 22ND AVE",
"city": "MIAMI",
"state": "FL",
"postal_code": "331428035",
"telephone_number": "305-637-6400"
}
],
"practiceLocations": [
{
"address_1": "3401 Civic Center Blvd 9NW Rm 55",
"address_2": "The Children's Hospital of Philadelphia",
"address_purpose": "LOCATION",
"city": "Philadelphia",
"state": "PA",
"postal_code": "19104",
"country_code": "US",
"telephone_number": "215-590-1220",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "DAVIS",
"first_name": "AMANDA",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-07-08",
"last_updated": "2025-03-25",
"certification_date": "2025-03-25",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "PA",
"license": "MT211860",
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "FL",
"license": "ME151594",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "111221200",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Miami, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.