MEDICARE: IVAN ALMANZA AMADOR

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103K00000X	Behavior Analyst
2	103K00000X	Behavior Analyst	RBT-25-429615	FL

General Provider Information

NPI Number	:	1588454573
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	IVAN ALMANZA AMADOR

Provider Business Mailing Address
First Line	:	2897 NEW YORK ST
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33406-4222
Country	:	US
Telephone Number	:	561-856-3812
Fax Number	:

Provider Business Practice Location Address
First Line	:	2897 NEW YORK ST
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33406-4222
Country	:	US
Telephone Number	:	561-856-3812
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/12/2025
Last Update Date	:	05/12/2025

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Directions to “ IVAN ALMANZA AMADOR ” Practice Location

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