Provider Demographics
NPI:1336656107
Name:FLORES MONTERO, AMALIX MARIA (MS BCABA)
Entity Type:Individual
Prefix:
First Name:AMALIX MARIA
Middle Name:
Last Name:FLORES MONTERO
Suffix:
Gender:F
Credentials:MS BCABA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2935 ANTIQUE OAKS CIR APT 58
Mailing Address - Street 2:
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32792-5634
Mailing Address - Country:US
Mailing Address - Phone:321-316-8401
Mailing Address - Fax:
Practice Address - Street 1:4417 E COLONIAL DR
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32803-5219
Practice Address - Country:US
Practice Address - Phone:407-745-1055
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-03
Last Update Date:2018-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL0-17-8234103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst