Active NPI
Grisellys Morales Vazquez
- Behavior Analyst
- Casselberry, FL
National Provider Identifier
1215409404
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 1-20-40861
- Practice address
- 148 Wilshire Blvd
Casselberry, FL 32707-5372 - Phone
- (866) 411-6619
- NPI assigned
- Dec 28, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | |||
| Behavior Technician | 106S00000X | |||
| Behavior Analyst | 103K00000X | 1-20-40861 | FL | Primary |
Addresses
Primary practice location
148 Wilshire Blvd
Casselberry, FL 32707-5372
Mailing address
134 Guadalajara Dr
Kissimmee, FL 34743-6606
Phone (407) 924-3428
Other practice location 1
1200 N Central Ave
Kissimmee, FL 34741-4450
Phone (407) 978-6085
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 020639700 | Medicaid | FL |
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
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hidden Potential Florida LLC | Behavior Analyst | Past | Accepting new patients |
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.
-
- Behavior Analyst
- Orlando, FL
- NPI 1508404211
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1545955200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1637107200000",
"number": "1215409404",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "134 GUADALAJARA DR",
"city": "KISSIMMEE",
"state": "FL",
"postal_code": "347436606",
"telephone_number": "407-924-3428"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "148 WILSHIRE BLVD",
"city": "CASSELBERRY",
"state": "FL",
"postal_code": "327075372",
"telephone_number": "866-411-6619"
}
],
"practiceLocations": [
{
"address_1": "1200 N Central Ave",
"address_purpose": "LOCATION",
"city": "Kissimmee",
"state": "FL",
"postal_code": "347414450",
"country_code": "US",
"telephone_number": "407-978-6085",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MORALES VAZQUEZ",
"first_name": "GRISELLYS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-12-28",
"last_updated": "2021-11-17",
"certification_date": "2021-11-17",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": null,
"license": null,
"primary": false
},
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": null,
"license": null,
"primary": false
},
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "FL",
"license": "1-20-40861",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "020639700",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Casselberry, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.