Healthcare Provider Details

I. General information

NPI: 1659870947
Provider Name (Legal Business Name): SANDRA MARIA CAAMANO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/02/2018
Last Update Date: 08/27/2026
Certification Date: 08/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3100 N 29TH CT STE 101
HOLLYWOOD FL
33020-1321
US

IV. Provider business mailing address

3100 N 29TH CT STE 101
HOLLYWOOD FL
33020-1321
US

V. Phone/Fax

Practice location:
  • Phone: 954-840-6701
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-18-53814
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: