Individual provider Active NPI

Juan Leonel Ravelo Oliva

  • Behavior Analyst
  • Lehigh Acres, FL
National Provider Identifier
1033968128
Registry record updated May 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
RBT-24-343787 Issued in FL
Practice address
5339 Centennial Blvd
Lehigh Acres, FL 33971-7555
Phone
(239) 671-7688
NPI assigned
May 13, 2024
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 15, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X RBT-24-343787 FL Primary

Addresses

Primary practice location

5339 Centennial Blvd
Lehigh Acres, FL 33971-7555

Mailing address

140 Gunnery Rd S
Lehigh Acres, FL 33973-2013
Phone (239) 671-7688

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
RBT-24-343787FLMDBehavioral Analyst

NPI Registry JSON

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

{
    "created_epoch": "1715558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715731200000",
    "number": "1033968128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140 GUNNERY RD S",
            "city": "LEHIGH ACRES",
            "state": "FL",
            "postal_code": "339732013",
            "telephone_number": "239-671-7688"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5339 CENTENNIAL BLVD",
            "city": "LEHIGH ACRES",
            "state": "FL",
            "postal_code": "339717555",
            "telephone_number": "239-671-7688"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAVELO OLIVA",
        "first_name": "JUAN",
        "middle_name": "LEONEL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-05-13",
        "last_updated": "2024-05-15",
        "certification_date": "2024-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "FL",
            "license": "RBT-24-343787",
            "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 May 15, 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.