MEDICARE: MARIA AMPARO DURA MORENO MS,BCBA

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		FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1730823873
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARIA AMPARO DURA MORENO MS,BCBA

Provider Business Mailing Address
First Line	:	PO BOX 222531
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33422-2531
Country	:	US
Telephone Number	:	305-333-5453
Fax Number	:

Provider Business Practice Location Address
First Line	:	188 KENT K
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33417-1722
Country	:	US
Telephone Number	:	305-333-5453
Fax Number	:

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

Provider Enumeration Date	:	04/25/2022
Last Update Date	:	04/25/2022

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