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General NPI Number Information
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NPI Number | 1568045615
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Entity Type | Organization
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Legal Business Name | AMA ANYWHERE
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Dates
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Enumeration Date | 05/05/2021
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Last Update Date | 06/02/2022
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Provider Practice Location Address
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Address Line | 3333 RENAISSANCE BLVD STE 223
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City | BONITA SPRINGS
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State | FL
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Zip | 34134-7008
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Country | US
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Telephone | 305-215-9531
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Fax |
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Provider Business Mailing Address
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Address Line | 3333 RENAISSANCE BLVD STE 223
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City | BONITA SPRINGS
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State | FL
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Zip | 34134-7008
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Country | US
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Telephone | 305-215-9531
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Fax |
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Authorized Official
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Title or Position | OFFICER
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Name | ALINA IGLESIAS VALLE
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Credential |
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Telephone | 305-215-9531
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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