Marielys Rodriguez Fonseca

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

Practice address

2151 Consulate Dr Ste 11
Orlando, FL 32837-8806

Phone

(386) 362-3926

Fax

(407) 641-9591

NPI assigned

Sep 30, 2021

Last updated

Sep 30, 2021By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Side by Side Behavioral Health LLC

  • Behavior Analyst
  • Orlando, FL
  • NPI 1194392514

  Behavior Technician

  NPD

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

{
    "created_epoch": "1632960000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632960000000",
    "number": "1073285854",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "247 CORALWOOD CT",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347438353",
            "telephone_number": "407-218-1583"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2151 CONSULATE DR STE 11",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328378806",
            "telephone_number": "386-362-3926",
            "fax_number": "407-641-9591"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ FONSECA",
        "first_name": "MARIELYS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-09-30",
        "last_updated": "2021-09-30",
        "certification_date": "2021-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "109002400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michelle Marie Rodriguez Diaz, PH.D.
• Ruth Noemi Rodriguez Dominguez
• Yianeyia Rodriguez Felipe
• Jenny De Jesus Rodriguez Fernandez
• Eliangely Rodriguez Figueroa
• Gretel Rodriguez Garcia, ARNP
• Melissa Rodriguez Garcia
• Sabrina A. Rodriguez Gil
• Francisco Steven Rodriguez Gomez, MD
• Maria D Rodriguez Gomez

• Behavior Technician in Orlando, FL
• Providers in Orlando, FL by specialty
• Behavior Technician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2021; 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.