MEDICARE: ALEXIS DANIELLE 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	RBT26521624	FL

General Provider Information

NPI Number	:	1760339113
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALEXIS DANIELLE ZAMORA

Provider Business Mailing Address
First Line	:	2400 S RIDGEWOOD AVE
Second Line	:	SUITE 17
City	:	SOUTH DAYTONA
State	:	FL
Zip	:	32119-3073
Country	:	US
Telephone Number	:	386-310-7879
Fax Number	:

Provider Business Practice Location Address
First Line	:	2400 S RIDGEWOOD AVE
Second Line	:	SUITE 17
City	:	SOUTH DAYTONA
State	:	FL
Zip	:	32119-3073
Country	:	US
Telephone Number	:	386-310-7879
Fax Number	:

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

Provider Enumeration Date	:	03/13/2026
Last Update Date	:	03/13/2026

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