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NPI Code Detail

MEDICARE: AMITY PRIOR

MEDICARE: AMITY PRIOR
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
1222Q00000XDevelopmental Therapist
2106S00000XBehavior Technician

General Provider Information

NPI Number : 1487055224
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMITY PRIOR
Provider Business Mailing Address
First Line : 204 TARRASA DR
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32225-3252
Country : US
Telephone Number : 904-254-7090
Fax Number :
Provider Business Practice Location Address
First Line : 9000 SOUTHSIDE BLVD BLDG 900
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32256-0791
Country : US
Telephone Number : 904-732-4343
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/11/2014
Last Update Date : 05/18/2021

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Directions to “ AMITY PRIOR ” Practice Location

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