Individual provider Active NPI

Mia Marie Nanez

  • Behavior Technician
  • Lehigh Acres, FL
National Provider Identifier
1033070503
Registry record updated Nov 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
License
BACB1350788 Issued in FL
Practice address
2906 E 12TH St Unit 2
Lehigh Acres, FL 33972-2530
Phone
(239) 710-9368
NPI assigned
Nov 22, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 22, 2025

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 BACB1350788 FL Primary

Addresses

Primary practice location

2906 E 12TH St Unit 2
Lehigh Acres, FL 33972-2530

Mailing address

2906 E 12TH St Unit 2
Lehigh Acres, FL 33972-2530
Phone (239) 710-9368

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
BACB1350788FLMDBehavior Technician

NPI Registry JSON

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

{
    "created_epoch": "1763769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763769600000",
    "number": "1033070503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2906 E 12TH ST UNIT 2",
            "city": "LEHIGH ACRES",
            "state": "FL",
            "postal_code": "339722530",
            "telephone_number": "239-710-9368"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2906 E 12TH ST UNIT 2",
            "city": "LEHIGH ACRES",
            "state": "FL",
            "postal_code": "339722530",
            "telephone_number": "239-710-9368"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NANEZ",
        "first_name": "MIA",
        "middle_name": "MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-11-22",
        "last_updated": "2025-11-22",
        "certification_date": "2025-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "FL",
            "license": "BACB1350788",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lehigh Acres, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 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.

Verify at the official NPI Registry.