Individual
AMIRA SUID
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW
Contact information
Practice address
200 E ROBINSON ST STE 200, ORLANDO, FL 32801-1969
(407) 440-4509
Mailing address
10738 GOLDFISH CIR, ORLANDO, FL 32825-4800
(407) 257-7751
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1041C0700X
—
FL
Enumeration date
07/07/2016
Last updated
07/07/2016
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