Individual
AMANDA JORGE GONZALEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
9711 MAGNOLIA WAY, TAMPA, FL 33635-5918
(317) 376-6572
Mailing address
9711 MAGNOLIA WAY, TAMPA, FL 33635-5918
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-24-326013
FL
Other
Enumeration date
04/25/2024
Last updated
05/07/2024
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