Individual provider Active NPI

Kaylin Angeliza Abreu

  • Behavior Technician
  • Wesley Chapel, FL
National Provider Identifier
1053916494
Registry record updated May 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
License
RBT-22-202347 Issued in FL
Practice address
30250 Southwell LN
Wesley Chapel, FL 33543-5926
Phone
(813) 470-9566
Fax
(844) 220-9322
NPI assigned
Dec 3, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 24, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X RBT-22-202347 FL
Behavior Technician 106S00000X RBT-22-202347 FL Primary

Addresses

Primary practice location

30250 Southwell LN
Wesley Chapel, FL 33543-5926

Mailing address

8910 N Dale Mabry Hwy Ste 38
Tampa, FL 33614-1500
Phone (813) 399-1396

Other identifiers 1

IdentifierTypeStateIssuer
108134800MedicaidFL

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-22-202347FLMDBehavior Technician

Practice roles

OrganizationSpecialtyStatusNew patients
Missing Piece ABA LLC Behavior Analyst CurrentSince May 28, 2023 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1606953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684886400000",
    "number": "1053916494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8910 N DALE MABRY HWY STE 38",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336141500",
            "telephone_number": "813-399-1396",
            "fax_number": "813-773-6569"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30250 SOUTHWELL LN",
            "city": "WESLEY CHAPEL",
            "state": "FL",
            "postal_code": "335435926",
            "telephone_number": "813-470-9566",
            "fax_number": "844-220-9322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABREU",
        "first_name": "KAYLIN",
        "middle_name": "ANGELIZA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-12-03",
        "last_updated": "2023-05-24",
        "certification_date": "2023-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "FL",
            "license": "RBT-22-202347",
            "primary": false
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "FL",
            "license": "RBT-22-202347",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "108134800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wesley Chapel, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2023; 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.