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General NPI Number Information
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NPI Number | 1730704180
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Entity Type | Individual
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Provider Name | DIAMANTE ROSA ALFONSO BCBA
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Gender | Female
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Dates
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Enumeration Date | 06/11/2020
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Last Update Date | 10/17/2025
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Provider Practice Location Address
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Address Line | 230 NW 5TH ST
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City | CAPE CORAL
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State | FL
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Zip | 33993-2300
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Country | US
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Telephone | 239-600-8171
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Fax |
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Provider Business Mailing Address
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Address Line | 8359 BEACON BLVD STE 416
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City | FORT MYERS
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State | FL
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Zip | 33907-3065
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | BCBA-1-25-84979
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number | RBT20121212
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License Number State | FL
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