Most Relevant Information
Provider Data
| NPI Number: | 1003662594 |
| Provider Name: | AMANDA JORGE GONZALEZ |
| Entity Type: | Individual |
| Taxonomy Code: | 106S00000X |
| Specialty: | Behavior Technician |
| License Number: | RBT-24-326013 |
Most Important Dates
| Enumeration Date: | 04/25/2024 |
| Last Updated: | 05/07/2024 |
Provider Practice Location
9711 MAGNOLIA WAY
TAMPA
FL
336355918
Practice Location Phone/Fax
| Phone: | 3173766572 |
| Fax: |
Provider Mailing Location
9711 MAGNOLIA WAY
TAMPA
FL
336355918
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |