# AMANDA PERSAUD

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1912562521
- **Gender:** F
- **Credential:** PA-C

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363A00000X | Physician Assistant | PA9112348 | FL | Yes |
| 363A00000X | Physician Assistant | — | — | — |

## Other

- **Enumeration date:** 05/08/2019
- **Last updated:** 11/15/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 105899900 | — | FL |
| 01 | — | G9W6I | BCBS | FL |
| 01 | — | PA9112348 | FLORIDA LICENCE | FL |