MEDICARE: MARIE D AMPARO

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	BACB986386	FL

General Provider Information

NPI Number	:	1861255390
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARIE D AMPARO

Provider Business Mailing Address
First Line	:	3000 CORAL WAY APT 1221
Second Line	:
City	:	CORAL GABLES
State	:	FL
Zip	:	33145-3240
Country	:	US
Telephone Number	:	305-987-4389
Fax Number	:

Provider Business Practice Location Address
First Line	:	3000 CORAL WAY APT 1221
Second Line	:
City	:	CORAL GABLES
State	:	FL
Zip	:	33145-3240
Country	:	US
Telephone Number	:	305-987-4389
Fax Number	:

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

Provider Enumeration Date	:	02/06/2024
Last Update Date	:	02/06/2024

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Directions to “ MARIE D AMPARO ” Practice Location

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