AMANDA BRENNER MD NPI 1104445113

NPI Information

  • NPI: 1104445113
  • Provider Name: AMANDA BRENNER, MD
  • Classification: Family Medicine - 207QG0300X
  • Specialization: Geriatric Medicine
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 2436 UNIVERSITY BLVD W
    JACKSONVILLE, FL
    ZIP 32217
  • Phone: (904) 916-1845

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NPI Details

Amanda Brenner, MD is a geriatric medicine family medicine in Jacksonville, FL. The provider is a family medicine physician with special knowledge of the aging process and special skills in the diagnostic, therapeutic, preventive and rehabilitative aspects of illness in the elderly. This specialist cares for geriatric patients in the patient's home, the office, long-term care settings such as nursing homes, and the hospital. Amanda Brenner, MD NPI is 1104445113. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

2436 UNIVERSITY BLVD W
JACKSONVILLE, FL
ZIP 32217-002
Phone: (904) 916-1845

The NPI 1104445113 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 4/9/2020 and was last updated on 8/21/2025.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1390200000XStudent in an Organized Health Care Education/Training ProgramNo
2207QG0300XFamily MedicineGeriatric MedicineME158502FLORIDAYes
3207Q00000XFamily MedicineME158502FLORIDANo
4208100000XPhysical Medicine & RehabilitationME158502FLORIDANo
5208M00000XHospitalistME158502FLORIDANo

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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