MEDICARE: AMANDA ZAMORA

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

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	:	1417642117
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMANDA ZAMORA

Provider Business Mailing Address
First Line	:	2335 CODY ST
Second Line	:
City	:	HOLLYWOOD
State	:	FL
Zip	:	33020-1423
Country	:	US
Telephone Number	:	786-760-6116
Fax Number	:

Provider Business Practice Location Address
First Line	:	2335 CODY ST
Second Line	:
City	:	HOLLYWOOD
State	:	FL
Zip	:	33020-1423
Country	:	US
Telephone Number	:	786-760-6116
Fax Number	:

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

Provider Enumeration Date	:	04/07/2023
Last Update Date	:	11/20/2024

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Directions to “ AMANDA ZAMORA ” Practice Location

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