MEDICARE: AMANDA MARANTE BCBA

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	103T00000X	Psychologist
2	106S00000X	Behavior Technician	RBT-19-91492	FL
3	103K00000X	Behavior Analyst	1-21-57191	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1215580527
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMANDA MARANTE BCBA

Provider Business Mailing Address
First Line	:	6725 MIAMI LAKES DR APT D314
Second Line	:
City	:	MIAMI LAKES
State	:	FL
Zip	:	33014-8139
Country	:	US
Telephone Number	:	305-781-4385
Fax Number	:

Provider Business Practice Location Address
First Line	:	6725 MIAMI LAKES DR APT D314
Second Line	:
City	:	MIAMI LAKES
State	:	FL
Zip	:	33014-8139
Country	:	US
Telephone Number	:	305-781-4385
Fax Number	:

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

Provider Enumeration Date	:	07/17/2019
Last Update Date	:	12/27/2021

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Directions to “ AMANDA MARANTE BCBA” Practice Location

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