Individual
AMARILIS P ORTA MATEO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CBHCM
Contact information
Practice address
1414 NW 107TH AVE STE 109, SWEETWATER, FL 33172-2739
(786) 762-2952
(786) 762-2953
Mailing address
11780 SW 18TH ST APT 209, MIAMI, FL 33175-1671
(305) 606-4571
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
CCM100064
FL
Other
Enumeration date
05/25/2018
Last updated
05/25/2018
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