MEDICARE: KATIA AMADOR RIVERA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106S00000X	Behavior Technician	RBT-24-347089	FL

General Provider Information

NPI Number	:	1144064163
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATIA AMADOR RIVERA

Provider Business Mailing Address
First Line	:	2135 NE 169TH ST APT 321
Second Line	:
City	:	NORTH MIAMI BEACH
State	:	FL
Zip	:	33162-3385
Country	:	US
Telephone Number	:	305-515-1558
Fax Number	:

Provider Business Practice Location Address
First Line	:	2135 NE 169TH ST APT 321
Second Line	:
City	:	NORTH MIAMI BEACH
State	:	FL
Zip	:	33162-3385
Country	:	US
Telephone Number	:	305-515-1558
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/24/2024
Last Update Date	:	06/24/2024

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Directions to “ KATIA AMADOR RIVERA ” Practice Location

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