Provider Demographics
NPI:1013534064
Name:CARMONA VALDES, AMANDA ROCIO (RBT)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:ROCIO
Last Name:CARMONA VALDES
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14551 SW 150TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33186-5643
Mailing Address - Country:US
Mailing Address - Phone:786-975-3823
Mailing Address - Fax:
Practice Address - Street 1:14551 SW 150TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33186-5643
Practice Address - Country:US
Practice Address - Phone:786-975-3823
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-25
Last Update Date:2020-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-20-116665106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician