Individual
AMANDA I PUERTO PEREZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1633 E VINE ST STE 205, KISSIMMEE, FL 34744-3736
(689) 200-4783
Mailing address
1495 W DONEGAN AVE APT B, KISSIMMEE, FL 34741-2030
(407) 757-5479
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-25-433404
FL
Other
Enumeration date
08/05/2025
Last updated
08/05/2025
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