Healthcare Provider Details

I. General information

NPI: 1790605889
Provider Name (Legal Business Name): IVANIELA AMADOR RBT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/17/2026
Last Update Date: 07/20/2026
Certification Date: 07/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2001 TYLER ST STE 215
HOLLYWOOD FL
33020-4578
US

IV. Provider business mailing address

7280 STIRLING RD APT 307
HOLLYWOOD FL
33024-1676
US

V. Phone/Fax

Practice location:
  • Phone: 786-629-1445
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: