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NPI Code Detail

MEDICARE: AMANI OVWIGHO

MEDICARE: AMANI OVWIGHO
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
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1992697957
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMANI OVWIGHO
Provider Business Mailing Address
First Line : 1337 THOMASVILLE CIR
Second Line :
City : LAKELAND
State : FL
Zip : 33811-3438
Country : US
Telephone Number : 678-876-6674
Fax Number :
Provider Business Practice Location Address
First Line : 4222 S FLORIDA AVE
Second Line :
City : LAKELAND
State : FL
Zip : 33813-1628
Country : US
Telephone Number : 863-456-7148
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/16/2025
Last Update Date : 04/13/2026

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