Active NPI
Rachel Puertas Lara
- Behavior Technician
- Lehigh Acres, FL
National Provider Identifier
1114782950
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- BACB967706
- Practice address
- 3217 15TH St SW
Lehigh Acres, FL 33976-2921 - Phone
- (786) 712-3655
- NPI assigned
- Feb 20, 2024
- Sex
- Female
- Sole proprietor
- Yes
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 | BACB967706 | FL | Primary |
Addresses
Primary practice location
3217 15TH St SW
Lehigh Acres, FL 33976-2921
Mailing address
3217 15TH St SW
Lehigh Acres, FL 33976-2921
Phone (786) 712-3655
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 |
|---|---|---|---|
| BACB967706 | FL | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1708387200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1708473600000",
"number": "1114782950",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3217 15TH ST SW",
"city": "LEHIGH ACRES",
"state": "FL",
"postal_code": "339762921",
"telephone_number": "786-712-3655"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3217 15TH ST SW",
"city": "LEHIGH ACRES",
"state": "FL",
"postal_code": "339762921",
"telephone_number": "786-712-3655"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PUERTAS LARA",
"first_name": "RACHEL",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-02-20",
"last_updated": "2024-02-21",
"certification_date": "2024-02-21",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "FL",
"license": "BACB967706",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lehigh Acres, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 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.