Individual provider Active NPI

Angel Katelyn Minerva

  • Behavior Analyst
  • Clermont, FL
National Provider Identifier
1245735455
Registry record updated Oct 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1-21-53880 Issued in FL
Practice address
2105 Hartwood Marsh Rd Ste 7
Clermont, FL 34711-5390
Phone
(407) 720-5067
NPI assigned
Mar 28, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X RBT-17-42286 FL
Behavior Analyst 103K00000X 1-21-53880 FL Primary

Addresses

Primary practice location

2105 Hartwood Marsh Rd Ste 7
Clermont, FL 34711-5390

Mailing address

16470 Glassy Loch Loop
Clermont, FL 34714-6608
Phone (321) 289-2551

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

State licenses

LicenseStateTypeSpecialty
RBT-17-42286FLMDBehavior Technician

NPI Registry JSON

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

{
    "created_epoch": "1522195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761696000000",
    "number": "1245735455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16470 GLASSY LOCH LOOP",
            "city": "CLERMONT",
            "state": "FL",
            "postal_code": "347146608",
            "telephone_number": "321-289-2551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2105 HARTWOOD MARSH RD STE 7",
            "city": "CLERMONT",
            "state": "FL",
            "postal_code": "347115390",
            "telephone_number": "407-720-5067"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MINERVA",
        "first_name": "ANGEL",
        "middle_name": "KATELYN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-28",
        "last_updated": "2025-10-29",
        "certification_date": "2025-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "FL",
            "license": "RBT-17-42286",
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "FL",
            "license": "1-21-53880",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clermont, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 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.