Individual provider Active NPI

Jordan C Garcia, RBT

  • Behavior Technician
  • Longwood, FL
National Provider Identifier
1013591205
Registry record updated May 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
License
RBT21155942 Issued in FL
Practice address
1939 Boothe Cir
Longwood, FL 32750-6774
Phone
(407) 218-4340
Fax
(407) 218-4303
NPI assigned
May 12, 2021
Last updated
May 12, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 12, 2021

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 RBT21155942 FL Primary

Addresses

Primary practice location

1939 Boothe Cir
Longwood, FL 32750-6774

Mailing address

1509 E Colonial Dr Ste 300
Orlando, FL 32803-4729
Phone (407) 218-4371

Other practice location 1

500 E Colonial Dr
Orlando, FL 32803-4510
Phone (407) 218-4340

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

State licenses

LicenseStateTypeSpecialty
RBT21155942FLMDBehavior Technician

Practice roles

OrganizationSpecialtyStatusNew patients
Life Concepts Inc PastSince May 16, 2021 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1620777600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620777600000",
    "number": "1013591205",
    "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": "407-218-4371",
            "fax_number": "407-218-4303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1939 BOOTHE CIR",
            "city": "LONGWOOD",
            "state": "FL",
            "postal_code": "327506774",
            "telephone_number": "407-218-4340",
            "fax_number": "407-218-4303"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "500 E Colonial Dr",
            "address_purpose": "LOCATION",
            "city": "Orlando",
            "state": "FL",
            "postal_code": "328034510",
            "country_code": "US",
            "telephone_number": "407-218-4340",
            "fax_number": "407-218-4303",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GARCIA",
        "first_name": "JORDAN",
        "middle_name": "C",
        "credential": "RBT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-05-12",
        "last_updated": "2021-05-12",
        "certification_date": "2021-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "FL",
            "license": "RBT21155942",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Longwood, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2021; 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.