Individual provider Active NPI

Alyse Lazaro

  • Behavior Technician
  • Odessa, FL
National Provider Identifier
1174014773
Registry record updated May 20, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
Practice address
16414 Lake Church Dr
Odessa, FL 33556-2637
Phone
(813) 926-5454
NPI assigned
May 20, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 20, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X FL Primary

Addresses

Primary practice location

16414 Lake Church Dr
Odessa, FL 33556-2637

Mailing address

5703 SW 108TH St
Ocala, FL 34476-9147
Phone (352) 502-6495

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

NPI Registry JSON

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

{
    "created_epoch": "1526774400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1526774400000",
    "number": "1174014773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5703 SW 108TH ST",
            "city": "OCALA",
            "state": "FL",
            "postal_code": "344769147",
            "telephone_number": "352-502-6495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16414 LAKE CHURCH DR",
            "city": "ODESSA",
            "state": "FL",
            "postal_code": "335562637",
            "telephone_number": "813-926-5454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAZARO",
        "first_name": "ALYSE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-05-20",
        "last_updated": "2018-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "FL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Odessa, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2018; 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.