Healthcare Provider Details

I. General information

NPI: 1215874482
Provider Name (Legal Business Name): AMANDA CARDONA ORDONEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/04/2026
Last Update Date: 05/11/2026
Certification Date: 05/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

680 S MILITARY TRL
WEST PALM BEACH FL
33415-3904
US

IV. Provider business mailing address

835 KAYE ST
WEST PALM BEACH FL
33405-2503
US

V. Phone/Fax

Practice location:
  • Phone: 561-335-7600
  • Fax:
Mailing address:
  • Phone: 561-672-5286
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-26-534169
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: