MEDICARE: AMANDA C DIAZ

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

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	:	1952078909
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMANDA C DIAZ

Provider Business Mailing Address
First Line	:	11239 NW 88TH AVE
Second Line	:
City	:	HIALEAH GARDENS
State	:	FL
Zip	:	33018-4530
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	11239 NW 88TH AVE
Second Line	:
City	:	HIALEAH GARDENS
State	:	FL
Zip	:	33018-4530
Country	:	US
Telephone Number	:	--
Fax Number	:

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

Provider Enumeration Date	:	08/26/2021
Last Update Date	:	08/27/2025

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Directions to “ AMANDA C DIAZ ” Practice Location

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