Provider Demographics
NPI:1679799647
Name:AMY M ZMISTOWSKI INC
Entity Type:Organization
Organization Name:AMY M ZMISTOWSKI INC
Other - Org Name:AMAZING KIDS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:AMY
Authorized Official - Middle Name:M
Authorized Official - Last Name:ZMISTOWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:MA, CCC-SLP
Authorized Official - Phone:786-525-9088
Mailing Address - Street 1:320 S FLAMINGO RD # 329
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33027-1770
Mailing Address - Country:US
Mailing Address - Phone:786-525-9088
Mailing Address - Fax:954-322-1207
Practice Address - Street 1:12112 SAINT ANDREWS PL APT 206
Practice Address - Street 2:
Practice Address - City:MIRAMAR
Practice Address - State:FL
Practice Address - Zip Code:33025-0705
Practice Address - Country:US
Practice Address - Phone:786-525-9088
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA5839235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty