NPIMap

Organization Active NPI

Energy Behavioral Therapy Corp

  • Behavior Analyst
  • Port St Lucie, FL
National Provider Identifier
1194437202
Registry record updated Dec 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Legal business name
ENERGY BEHAVIORAL THERAPY CORP
Practice address
1701 SE Tiffany Ave Ste 102
Port St Lucie, FL 34952-7576
Phone
(786) 227-2966
NPI assigned
Dec 20, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2022

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

Authorized official

Name
Ernesto Rodriguez Tanquero
Title
President
Phone
(786) 227-2966

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior AnalystGroup: 193400000X SINGLE SPECIALTY GROUP 103K00000X Primary

Addresses

Primary practice location

1701 SE Tiffany Ave Ste 102
Port St Lucie, FL 34952-7576

Mailing address

1701 SE Tiffany Ave Ste 102
Port St Lucie, FL 34952-7576
Phone (786) 227-2966

National Provider Directory

National Provider Directory

Locations

1701 SE Tiffany Ave
Ste 102
Port St Lucie, FL 34952
Phone (772) 732-0000

NPI Registry JSON

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

{
    "created_epoch": "1671494400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1671494400000",
    "number": "1194437202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1701 SE TIFFANY AVE STE 102",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349527576",
            "telephone_number": "786-227-2966"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 SE TIFFANY AVE STE 102",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349527576",
            "telephone_number": "786-227-2966"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ENERGY BEHAVIORAL THERAPY CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-12-20",
        "last_updated": "2022-12-20",
        "certification_date": "2022-12-20",
        "status": "A",
        "authorized_official_last_name": "RODRIGUEZ TANQUERO",
        "authorized_official_first_name": "ERNESTO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "786-227-2966"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port St Lucie, FL

Sources for this page

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