Healthcare Provider Details

I. General information

NPI: 1124633607
Provider Name (Legal Business Name): LIZANDRA AMORES
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/11/2020
Last Update Date: 12/12/2025
Certification Date: 12/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15225 SW 235TH ST
HOMESTEAD FL
33032-2030
US

IV. Provider business mailing address

15225 SW 235TH ST
HOMESTEAD FL
33032-2030
US

V. Phone/Fax

Practice location:
  • Phone: 786-580-2111
  • Fax:
Mailing address:
  • Phone: 786-580-2111
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-20-129283
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: