Individual provider Active NPI

Dyandra Ortiz Victoria, RBT

  • Behavior Technician
  • West Palm BCH, FL
National Provider Identifier
1053833004
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
Practice address
5065 Palm Hill Dr Apt U322
West Palm BCH, FL 33415-5706
Phone
(561) 720-3717
NPI assigned
Jul 12, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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 Primary

Addresses

Primary practice location

5065 Palm Hill Dr Apt U322
West Palm BCH, FL 33415-5706

Mailing address

10850 S US Highway 1 Ste 2
Port St Lucie, FL 34952-6407
Phone (561) 720-3717

Other practice location 1

521 hunter st
apt 1
west palm beach, FL 33405
Phone (561) 768-6396

Other practice location 2

521 hunter st
apt 1
west palm beach, FL 33405
Phone (561) 768-6396

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": "1499817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1053833004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10850 S US HIGHWAY 1 STE 2",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349526407",
            "telephone_number": "561-720-3717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5065 PALM HILL DR APT U322",
            "city": "WEST PALM BCH",
            "state": "FL",
            "postal_code": "334155706",
            "telephone_number": "561-720-3717"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "521 hunter st",
            "address_2": "apt 1",
            "address_purpose": "LOCATION",
            "city": "west palm beach",
            "state": "FL",
            "postal_code": "33405",
            "country_code": "US",
            "telephone_number": "15617686396",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "521 hunter st",
            "address_2": "apt 1",
            "address_purpose": "LOCATION",
            "city": "west palm beach",
            "state": "FL",
            "postal_code": "33405",
            "country_code": "US",
            "telephone_number": "15617686396",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ORTIZ VICTORIA",
        "first_name": "DYANDRA",
        "credential": "RBT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-07-12",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Palm BCH, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.