Individual provider Active NPI

Annelis Lopez Perez

  • Behavior Technician
  • Fort Myers, FL
National Provider Identifier
1215515903
Registry record updated Jan 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
Practice address
11922 Fairway Lakes Dr Ste 2
Fort Myers, FL 33913-8384
Phone
(239) 219-3409
NPI assigned
Apr 1, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X Primary

Addresses

Primary practice location

11922 Fairway Lakes Dr Ste 2
Fort Myers, FL 33913-8384

Mailing address

5353 Hawks Landing Dr Apt 207
Fort Myers, FL 33907-6665
Phone (239) 288-3823

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
Umbrella Spectrum LLC CurrentSince Aug 1, 2021 Accepting new patients

Locations

11922 Fairway Lakes Dr
Ste 2
Fort Myers, FL 33913
Phone (239) 219-3409

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": "1617235200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736121600000",
    "number": "1215515903",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5353 HAWKS LANDING DR APT 207",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339076665",
            "telephone_number": "239-288-3823"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11922 FAIRWAY LAKES DR STE 2",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339138384",
            "telephone_number": "239-219-3409"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOPEZ PEREZ",
        "first_name": "ANNELIS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-01",
        "last_updated": "2025-01-06",
        "certification_date": "2025-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "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 Jan 6, 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.