Individual provider Active NPI

Mia Gomez

  • Behavior Technician
  • Orange City, FL
National Provider Identifier
1215752779
Registry record updated Sep 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
Practice address
2730 Enterprise Rd
Orange City, FL 32763-8320
Phone
(877) 823-4283
NPI assigned
Nov 20, 2024
Last updated
Sep 2, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2026

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

2730 Enterprise Rd
Orange City, FL 32763-8320

Mailing address

745 Orienta Ave Ste 1011
Altamonte Springs, FL 32701-5675

Other practice location 1

537 Deltona Blvd
Deltona, FL 32725-8017
Phone (904) 878-8683

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
Behavioral Foundation Centers Inc CurrentSince Nov 24, 2024 Accepting new patients
Exceptional Learning Institute, Inc CurrentSince Nov 24, 2024 Accepting new patients

Locations

537 Deltona Blvd
Deltona, FL 32725
Phone (386) 235-9621

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1732060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788307200000",
    "number": "1215752779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "745 ORIENTA AVE STE 1011",
            "city": "ALTAMONTE SPRINGS",
            "state": "FL",
            "postal_code": "327015675"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2730 ENTERPRISE RD",
            "city": "ORANGE CITY",
            "state": "FL",
            "postal_code": "327638320",
            "telephone_number": "877-823-4283"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "537 Deltona Blvd",
            "address_purpose": "LOCATION",
            "city": "Deltona",
            "state": "FL",
            "postal_code": "327258017",
            "country_code": "US",
            "telephone_number": "904-878-8683",
            "fax_number": "386-200-5752",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GOMEZ",
        "first_name": "MIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-11-20",
        "last_updated": "2026-09-02",
        "certification_date": "2026-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange City, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 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.

Verify at the official NPI Registry.