Provider Demographics
NPI:1134011794
Name:GERASIMCHIK, AMBER NICOLE (AUD)
Entity type:Individual
Prefix:
First Name:AMBER
Middle Name:NICOLE
Last Name:GERASIMCHIK
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2020 N 55TH AVE
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33021-3940
Mailing Address - Country:US
Mailing Address - Phone:954-558-5614
Mailing Address - Fax:
Practice Address - Street 1:7135 NW 11TH PL
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32605-3159
Practice Address - Country:US
Practice Address - Phone:352-331-0090
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-17
Last Update Date:2025-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAY2945231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist