Jorge Amado Roque Blanco

NPI #1992220453 in Lehigh Acres, Florida

Provider Information

NPI Number: 1992220453
Entity Type: Individual
Name: Jorge Amado Roque Blanco
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Behavior Technician
Enumeration Date: Aug 7, 2017
Last Updated: Jul 21, 2022

Practice Location

Address: 1412 JUDDALE ST E
City: Lehigh Acres
State: Florida
ZIP Code: 33936-5812
Phone: (239) 240-4511

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Behavior Technician	106S00000X	Primary

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