Individual provider Active NPI

Angel M Gonzalez Montero

  • Assistant Behavior Analyst
  • Kissimmee, FL
National Provider Identifier
1124681002
Registry record updated Dec 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assistant Behavior AnalystTaxonomy code 106E00000X
Practice address
3501 W Vine St Ste 115
Kissimmee, FL 34741-4644
Phone
(407) 483-3074
NPI assigned
Apr 17, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 5, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior TechnicianGroup: 193400000X SINGLE SPECIALTY GROUP 106S00000X FL
Assistant Behavior AnalystGroup: 193400000X SINGLE SPECIALTY GROUP 106E00000X FL Primary

Addresses

Primary practice location

3501 W Vine St Ste 115
Kissimmee, FL 34741-4644

Mailing address

2484 Huron Cir
Kissimmee, FL 34746-3439
Phone (321) 287-1608

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

Practice roles

OrganizationSpecialtyStatusNew patients
ABA Tree of Functional Skills LLC Single Specialty PastSince Dec 13, 2022 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": "1555459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670198400000",
    "number": "1124681002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2484 HURON CIR",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347463439",
            "telephone_number": "321-287-1608"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3501 W VINE ST STE 115",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347414644",
            "telephone_number": "407-483-3074"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ MONTERO",
        "first_name": "ANGEL",
        "middle_name": "M",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-04-17",
        "last_updated": "2022-12-05",
        "certification_date": "2022-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Behavior Technician",
            "state": "FL",
            "license": null,
            "primary": false
        },
        {
            "code": "106E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Assistant Behavior Analyst",
            "state": "FL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kissimmee, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2022; 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.