Healthcare Provider Details

I. General information

NPI: 1760352447
Provider Name (Legal Business Name): AMAZING DEVELOPMENT CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/07/2025
Last Update Date: 04/16/2026
Certification Date: 04/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7483 67TH PL
LIVE OAK FL
32060-7477
US

IV. Provider business mailing address

7483 67TH PL
LIVE OAK FL
32060-7477
US

V. Phone/Fax

Practice location:
  • Phone: 727-325-4036
  • Fax:
Mailing address:
  • Phone: 727-325-4036
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name: MRS. JOHANA I CRUZ SANTIAGO
Title or Position: OWNER / ADMINISTRATOR
Credential:
Phone: 727-325-4036