Provider Demographics
NPI:1053600874
Name:AMER, MAGDA M (MD)
Entity type:Individual
Prefix:
First Name:MAGDA
Middle Name:M
Last Name:AMER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:57 FOXCROFT RUN
Mailing Address - Street 2:
Mailing Address - City:ORMOND BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32174-2476
Mailing Address - Country:US
Mailing Address - Phone:201-282-1690
Mailing Address - Fax:386-676-7125
Practice Address - Street 1:309 PALM COAST PKWY NE
Practice Address - Street 2:
Practice Address - City:PALM COAST
Practice Address - State:FL
Practice Address - Zip Code:32137-3886
Practice Address - Country:US
Practice Address - Phone:386-254-4242
Practice Address - Fax:386-258-4858
Is Sole Proprietor?:No
Enumeration Date:2011-04-01
Last Update Date:2021-03-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME123465207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1524HOtherBCBS
FL1053600874OtherTRICARE
FL015990000Medicaid
FLII497ZMedicare PIN