Active NPI
Adelaida Beatriz Garcia Dominguez
- Behavior Technician
- St Augustine, FL
National Provider Identifier
1013766781
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- Practice address
- 100 Ventures Dr Apt 1411
Saint Augustine, FL 32095-0180 - Phone
- (305) 283-6728
- NPI assigned
- May 15, 2024
- Last updated
- Jan 25, 2025
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | 24-332079 | CO | |
| Behavior Technician | 106S00000X | NU | Primary |
Addresses
Primary practice location
100 Ventures Dr Apt 1411
Saint Augustine, FL 32095-0180
Mailing address
100 Ventures Dr Apt 1411
Saint Augustine, FL 32095-0180
Phone (305) 283-6728
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
| License | State | Type | Specialty |
|---|---|---|---|
| 24-332079 | CO | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1715731200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1737763200000",
"number": "1013766781",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "100 VENTURES DR APT 1411",
"city": "SAINT AUGUSTINE",
"state": "FL",
"postal_code": "320950180",
"telephone_number": "305-283-6728"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 VENTURES DR APT 1411",
"city": "SAINT AUGUSTINE",
"state": "FL",
"postal_code": "320950180",
"telephone_number": "305-283-6728"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GARCIA DOMINGUEZ",
"first_name": "ADELAIDA",
"middle_name": "BEATRIZ",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-05-15",
"last_updated": "2025-01-25",
"certification_date": "2025-01-25",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "CO",
"license": "24-332079",
"primary": false
},
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in St Augustine, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.