MEDICARE: MARIA ALEJANDRA MORA AMAZO

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	106E00000X	Assistant Behavior Analyst	0-18-8753	FL
2	247200000X	Other Technician
3	103K00000X	Behavior Analyst	1-24-71539	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	:	1831644830
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARIA ALEJANDRA MORA AMAZO

Provider Business Mailing Address
First Line	:	11841 HERMITAGE DR
Second Line	:
City	:	PLANTATION
State	:	FL
Zip	:	33325-3511
Country	:	US
Telephone Number	:	754-300-0284
Fax Number	:

Provider Business Practice Location Address
First Line	:	1880 N CONGRESS AVE STE 311
Second Line	:
City	:	BOYNTON BEACH
State	:	FL
Zip	:	33426-8675
Country	:	US
Telephone Number	:	844-424-4539
Fax Number	:

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

Provider Enumeration Date	:	08/18/2016
Last Update Date	:	05/03/2024

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