Active NPI
Laura Dezayas, BCBA
- Behavior Analyst
- Gainesville, FL
National Provider Identifier
1154891836
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 12261940
- Practice address
- 4101 NW 89TH Blvd
Gainesville, FL 32606-3813 - Phone
- (352) 554-9162
- Fax
- (352) 608-9203
- NPI assigned
- Nov 26, 2018
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Assistant Behavior Analyst | 106E00000X | 0-19-10487 | FL | |
| Behavior Technician | 106S00000X | 1620049 | FL | |
| Behavior Analyst | 103K00000X | 12261940 | FL | Primary |
Addresses
Primary practice location
4101 NW 89TH Blvd
Gainesville, FL 32606-3813
Mailing address
300 International Parkway
Ste 200
Lake Mary, FL 32746
Phone (407) 915-7729
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 |
|---|---|---|---|
| 12261940 | FL | MD | Behavioral Analyst |
| 1620049 | FL | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1543190400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1698105600000",
"number": "1154891836",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "300 INTERNATIONAL PARKWAY",
"address_2": "STE 200",
"city": "LAKE MARY",
"state": "FL",
"postal_code": "32746",
"telephone_number": "407-915-7729",
"fax_number": "407-588-6294"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4101 NW 89TH BLVD",
"city": "GAINESVILLE",
"state": "FL",
"postal_code": "326063813",
"telephone_number": "352-554-9162",
"fax_number": "352-608-9203"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEZAYAS",
"first_name": "LAURA",
"credential": "BCBA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-11-26",
"last_updated": "2023-10-24",
"certification_date": "2023-10-23",
"status": "A"
},
"taxonomies": [
{
"code": "106E00000X",
"taxonomy_group": "",
"desc": "Assistant Behavior Analyst",
"state": "FL",
"license": "0-19-10487",
"primary": false
},
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "FL",
"license": "1620049",
"primary": false
},
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "FL",
"license": "12261940",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gainesville, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.