Healthcare Provider Details

I. General information

NPI: 1790561330
Provider Name (Legal Business Name): AMANDA MAS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/07/2023
Last Update Date: 09/24/2026
Certification Date: 09/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13370 SW 131ST ST STE 104
MIAMI FL
33186-5856
US

IV. Provider business mailing address

8451 NW 163RD TER
MIAMI LAKES FL
33016-6634
US

V. Phone/Fax

Practice location:
  • Phone: 786-581-9644
  • Fax:
Mailing address:
  • Phone: 786-567-1898
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License Number
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-23-292137
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: