Individual provider Active NPI

Sucel Tejeda, BCBA,RN

  • Behavior Analyst
  • Fort Myers Beach, FL
National Provider Identifier
1134577513
Registry record updated Sep 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Practice address
6660 Estero Blvd Unit B404
Fort Myers Beach, FL 33931-4567
Phone
(239) 628-6999
NPI assigned
May 26, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X
Behavior Analyst 103K00000X FL Primary

Addresses

Primary practice location

6660 Estero Blvd Unit B404
Fort Myers Beach, FL 33931-4567

Mailing address

6660 Estero Blvd Unit B404
Fort Myers Beach, FL 33931-4567
Phone (239) 628-6999

Other practice location 1

11328 Lakeland Cir
Fort Myers, FL 33913-6913
Phone (239) 628-6999

Other identifiers 1

IdentifierTypeStateIssuer
018935400MedicaidFL

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
Credentials
Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Abaswf of Texas Corp Behavior Analyst Current Accepting new patients
ABA of Southwest Florida Corp. Behavior Analyst CurrentSince Jul 25, 2019 Accepting new patients

Locations

5245 Ramsey Way
Ste 5
Fort Myers, FL 33907
Phone (239) 691-6482

5318 Weslayan St
Houston, TX 77005
Phone (502) 404-1434

Organizations & group practices 2

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": "1464220800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726444800000",
    "number": "1134577513",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6660 ESTERO BLVD UNIT B404",
            "city": "FORT MYERS BEACH",
            "state": "FL",
            "postal_code": "339314567",
            "telephone_number": "239-628-6999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6660 ESTERO BLVD UNIT B404",
            "city": "FORT MYERS BEACH",
            "state": "FL",
            "postal_code": "339314567",
            "telephone_number": "239-628-6999"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11328 Lakeland Cir",
            "address_purpose": "LOCATION",
            "city": "Fort Myers",
            "state": "FL",
            "postal_code": "339136913",
            "country_code": "US",
            "telephone_number": "239-628-6999",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TEJEDA",
        "first_name": "SUCEL",
        "credential": "BCBA,RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-26",
        "last_updated": "2024-09-16",
        "certification_date": "2024-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "FL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "018935400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Myers Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 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.

Verify at the official NPI Registry.