Juan Camilo Coronel Ruiz

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

License

RBT-24-388580 Issued in FL

Practice address

13508 Avalon Heights Blvd
Tampa, FL 33613-4939

Phone

(786) 948-3611

NPI assigned

Oct 28, 2024

Last updated

Oct 28, 2024By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1730073600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730073600000",
    "number": "1164244455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13508 AVALON HEIGHTS BLVD",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336134939",
            "telephone_number": "786-948-3611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13508 AVALON HEIGHTS BLVD",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336134939",
            "telephone_number": "786-948-3611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORONEL RUIZ",
        "first_name": "JUAN",
        "middle_name": "CAMILO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-10-28",
        "last_updated": "2024-10-28",
        "certification_date": "2024-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "FL",
            "license": "RBT-24-388580",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cassidy Stampfer Cornish, LMT
• Jacob Cornman, CAA
• Lindsey B Cornwell
• Enrique E Corona Menendez
• Tiana Coronado
• Erick R Corps, DC
• Cynthia Corr, PHARMD, CPH
• Kent Richardson Corral, M.D.
• Rafael Corrales Mendoza
• Liuvan Corrales, LMT

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 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.