Individual provider Active NPI

Carolina Dinorah Corredor de Landa, RBT

  • Behavior Technician
  • Kissimmee, FL
National Provider Identifier
1194298323
Registry record updated Apr 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
Practice address
3501 W Vine St Ste 124
Kissimmee, FL 34741-4660
Phone
(407) 483-3074
NPI assigned
Jan 10, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 20, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior TechnicianGroup: 193400000X SINGLE SPECIALTY GROUP 106S00000X FL Primary

Addresses

Primary practice location

3501 W Vine St Ste 124
Kissimmee, FL 34741-4660

Mailing address

2317 Silver Palm Dr
Kissimmee, FL 34747-2708
Phone (407) 724-9111

Other practice location 1

3501 W Vine St
Kissimmee, FL 34741-4643
Phone (407) 483-3074

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
A Boundless Care Inc CurrentSince Apr 24, 2022 Accepting new patients

Locations

3501 W Vine St
Ste 124
Kissimmee, FL 34741
Phone (407) 483-3074

Organizations & group practices 1

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": "1547078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650412800000",
    "number": "1194298323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2317 SILVER PALM DR",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347472708",
            "telephone_number": "407-724-9111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3501 W VINE ST STE 124",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347414660",
            "telephone_number": "407-483-3074"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3501 W Vine St",
            "address_purpose": "LOCATION",
            "city": "Kissimmee",
            "state": "FL",
            "postal_code": "347414643",
            "country_code": "US",
            "telephone_number": "407-483-3074",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CORREDOR DE LANDA",
        "first_name": "CAROLINA",
        "middle_name": "DINORAH",
        "credential": "RBT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-01-10",
        "last_updated": "2022-04-20",
        "certification_date": "2022-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Behavior Technician",
            "state": "FL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kissimmee, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2022; 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.