Individual provider Active NPI

Lucia Gabriela Mostaffa Di Martino, RBT

  • Behavior Technician
  • Winter Park, FL
National Provider Identifier
1003673625
Registry record updated Nov 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
Practice address
2134 Kentucky Ave
Winter Park, FL 32789-4535
Phone
(407) 317-5429
Fax
(321) 800-7201
NPI assigned
Feb 29, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X FL Primary

Addresses

Primary practice location

2134 Kentucky Ave
Winter Park, FL 32789-4535

Mailing address

1509 E Colonial Dr Ste 300
Orlando, FL 32803-4729
Phone (407) 317-5429

Other practice location 1

6973 University Blvd
Winter Park, FL 32792-6713
Phone (888) 754-0398

Other identifiers 1

IdentifierTypeStateIssuer
122055700MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1709164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730937600000",
    "number": "1003673625",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1509 E COLONIAL DR STE 300",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328034729",
            "telephone_number": "407-317-5429",
            "fax_number": "321-800-7201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2134 KENTUCKY AVE",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327894535",
            "telephone_number": "407-317-5429",
            "fax_number": "321-800-7201"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6973 University Blvd",
            "address_purpose": "LOCATION",
            "city": "Winter Park",
            "state": "FL",
            "postal_code": "327926713",
            "country_code": "US",
            "telephone_number": "888-754-0398",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOSTAFFA DI MARTINO",
        "first_name": "LUCIA",
        "middle_name": "GABRIELA",
        "credential": "RBT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-02-29",
        "last_updated": "2024-11-07",
        "certification_date": "2024-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "FL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "122055700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Winter Park, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.