Individual provider Active NPI

Amy Lynn Brink, D.O.

  • Pediatrics Physician
  • Tampa, FL
National Provider Identifier
1629509922
Registry record updated Oct 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
OS16781 Issued in FL
Practice address
3910 Northdale Blvd Ste 204
Tampa, FL 33624-1800
Phone
(813) 570-6971
Fax
(813) 570-6977
NPI assigned
Mar 27, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X OS16781 FL Primary

Addresses

Primary practice location

3910 Northdale Blvd Ste 204
Tampa, FL 33624-1800

Mailing address

3910 Northdale Blvd Ste 204
Tampa, FL 33624-1800
Phone (813) 570-6971

Other practice location 1

12871 Citrus Plaza Dr
Tampa, FL 33625-3010
Phone (813) 471-4445

Other identifiers 2

IdentifierTypeStateIssuer
LXM1QOtherFLBCBS
106450400MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
OS16781FLMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Orlando Health, Inc. Current Accepting new patients
Florida Pediatric Associates LLC Pediatrics PastSince Apr 20, 2025 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: awilson214065@orlandohealth.medalliesdirect.net

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1490572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760054400000",
    "number": "1629509922",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3910 NORTHDALE BLVD STE 204",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336241800",
            "telephone_number": "813-570-6971"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3910 NORTHDALE BLVD STE 204",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336241800",
            "telephone_number": "813-570-6971",
            "fax_number": "813-570-6977"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12871 Citrus Plaza Dr",
            "address_purpose": "LOCATION",
            "city": "Tampa",
            "state": "FL",
            "postal_code": "336253010",
            "country_code": "US",
            "telephone_number": "813-471-4445",
            "fax_number": "813-343-5022",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRINK",
        "first_name": "AMY",
        "middle_name": "LYNN",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-27",
        "last_updated": "2025-10-10",
        "certification_date": "2025-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "OS16781",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "LXM1Q",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "106450400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.