Active NPI
Miguel Gonzalez Fernandez
- Behavior Technician
- Fort Myers, FL
National Provider Identifier
1174324859
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- 25420283
- Practice address
- 9777 Stella Palm Way Unit 420
Fort Myers, FL 33966-6600 - Phone
- (786) 445-8247
- NPI assigned
- Mar 20, 2025
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | 25420283 | FL | Primary |
Addresses
Primary practice location
9777 Stella Palm Way Unit 420
Fort Myers, FL 33966-6600
Mailing address
9777 Stella Palm Way Unit 420
Fort Myers, FL 33966-6600
Phone (786) 445-8247
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 |
|---|---|---|---|
| 25420283 | FL | MD | Behavioral Analyst |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1742428800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1784678400000",
"number": "1174324859",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9777 STELLA PALM WAY UNIT 420",
"city": "FORT MYERS",
"state": "FL",
"postal_code": "339666600",
"telephone_number": "786-445-8247"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9777 STELLA PALM WAY UNIT 420",
"city": "FORT MYERS",
"state": "FL",
"postal_code": "339666600",
"telephone_number": "786-445-8247"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GONZALEZ FERNANDEZ",
"first_name": "MIGUEL",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2025-03-20",
"last_updated": "2026-07-22",
"certification_date": "2026-07-22",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "FL",
"license": "25420283",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Myers, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.