Individual provider Active NPI

Fernando A. Elizarraras

  • Behavior Analyst
  • Saint Cloud, FL
National Provider Identifier
1174267769
Registry record updated Oct 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1-25-85375 Issued in FL
Practice address
311 Commerce Center Dr
Saint Cloud, FL 34769-1549
Phone
(407) 989-4040
Fax
(407) 989-4040
NPI assigned
Apr 21, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 30, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X FL
Behavior Analyst 103K00000X 1-25-85375 FL Primary

Addresses

Primary practice location

311 Commerce Center Dr
Saint Cloud, FL 34769-1549

Mailing address

311 Commerce Center Dr
Saint Cloud, FL 34769-1549
Phone (407) 989-4040

Other identifiers 1

IdentifierTypeStateIssuer
114072100MedicaidFL

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
Kids Corner Behavior Services Inc Behavior Analyst CurrentSince Nov 8, 2025 Accepting new patients
Kids Corner Behavior Services Inc Behavior Analyst CurrentSince Nov 8, 2025 Accepting new patients

Locations

311 Commerce Center Dr
Saint Cloud, FL 34769
Phone (407) 989-4040

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": "1650499200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761782400000",
    "number": "1174267769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "311 COMMERCE CENTER DR",
            "city": "SAINT CLOUD",
            "state": "FL",
            "postal_code": "347691549",
            "telephone_number": "407-989-4040",
            "fax_number": "407-989-4040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "311 COMMERCE CENTER DR",
            "city": "SAINT CLOUD",
            "state": "FL",
            "postal_code": "347691549",
            "telephone_number": "407-989-4040",
            "fax_number": "407-989-4040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELIZARRARAS",
        "first_name": "FERNANDO",
        "middle_name": "A.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-04-21",
        "last_updated": "2025-10-30",
        "certification_date": "2025-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "FL",
            "license": null,
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "FL",
            "license": "1-25-85375",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "114072100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Cloud, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2025; 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.