Active NPI
Vonique Petersen
- Behavior Technician
- Davenport, FL
National Provider Identifier
1063349611
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- Practice address
- 103 Ridge Center Dr Ste 211
Davenport, FL 33837-6401 - Phone
- (407) 329-3464
- NPI assigned
- May 7, 2026
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | FL | Primary |
Addresses
Primary practice location
103 Ridge Center Dr Ste 211
Davenport, FL 33837-6401
Mailing address
4841 Butler National Dr
Wesley Chapel, FL 33543-7137
Phone (340) 277-5761
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": "1778112000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1778112000000",
"number": "1063349611",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4841 BUTLER NATIONAL DR",
"city": "WESLEY CHAPEL",
"state": "FL",
"postal_code": "335437137",
"telephone_number": "340-277-5761"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "103 RIDGE CENTER DR STE 211",
"city": "DAVENPORT",
"state": "FL",
"postal_code": "338376401",
"telephone_number": "407-329-3464"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETERSEN",
"first_name": "VONIQUE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2026-05-07",
"last_updated": "2026-05-07",
"certification_date": "2026-05-07",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "FL",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Davenport, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.