MEDICARE: AMAZING DEVELOPMENT CARE, LLC

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

General Provider Information

NPI Number	:	1760352447
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AMAZING DEVELOPMENT CARE, LLC

Provider Business Mailing Address
First Line	:	7483 67TH PL
Second Line	:
City	:	LIVE OAK
State	:	FL
Zip	:	32060-7477
Country	:	US
Telephone Number	:	727-325-4036
Fax Number	:

Provider Business Practice Location Address
First Line	:	7483 67TH PL
Second Line	:
City	:	LIVE OAK
State	:	FL
Zip	:	32060-7477
Country	:	US
Telephone Number	:	727-325-4036
Fax Number	:

Authorized Official
Title or Position	:	OWNER / ADMINISTRATOR
Name	:	MRS. JOHANA I CRUZ SANTIAGO
Credential	:
Telephone Number	:	727-325-4036

Provider Enumeration Date	:	11/07/2025
Last Update Date	:	04/16/2026

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Directions to “AMAZING DEVELOPMENT CARE, LLC ” Practice Location

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