Active NPI
Jacive Rodriguez
- Behavior Technician
- Melbourne, FL
National Provider Identifier
1063289668
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- Practice address
- 1435 Aurora Rd
Melbourne, FL 32935-5315 - Phone
- (213) 541-1970
- NPI assigned
- Dec 5, 2023
- Sex
- Female
- Sole proprietor
- No
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 | FL | Primary | |
| Behavior Analyst | 103K00000X | 23308089 | FL |
Addresses
Primary practice location
1435 Aurora Rd
Melbourne, FL 32935-5315
Mailing address
325 E University Blvd
Melbourne, FL 32901-7054
Phone (786) 879-3901
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 |
|---|---|---|---|
| 23308089 | FL | MD | Behavioral Analyst |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1701734400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1721347200000",
"number": "1063289668",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "325 E UNIVERSITY BLVD",
"city": "MELBOURNE",
"state": "FL",
"postal_code": "329017054",
"telephone_number": "786-879-3901"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1435 AURORA RD",
"city": "MELBOURNE",
"state": "FL",
"postal_code": "329355315",
"telephone_number": "213-541-1970"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RODRIGUEZ",
"first_name": "JACIVE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-12-05",
"last_updated": "2024-07-19",
"certification_date": "2024-07-19",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "FL",
"license": null,
"primary": true
},
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "FL",
"license": "23308089",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Melbourne, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 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.