Active NPI
Ivelyn Guerra Rodriguez, RBT
- Behavior Technician
- Lake Worth, FL
National Provider Identifier
1245801018
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- RBT21-159043
- Practice address
- 1508 19TH Ave N # 561
Lake Worth, FL 33460-6064 - Phone
- (561) 377-9760
- NPI assigned
- Jul 2, 2021
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Agency | 251E00000X | |||
| Behavior Technician | 106S00000X | RBT21-159043 | FL | Primary |
Addresses
Primary practice location
1508 19TH Ave N # 561
Lake Worth, FL 33460-6064
Mailing address
1508 19TH Ave N
Lake Worth, FL 33460-6064
Phone (561) 377-9760
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 110625000 | Medicaid | FL |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | ivelynguerra@gmail.com | Direct |
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
| License | State | Type | Specialty |
|---|---|---|---|
| RBT21-159043 | FL | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1625184000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1629936000000",
"number": "1245801018",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1508 19TH AVE N",
"city": "LAKE WORTH",
"state": "FL",
"postal_code": "334606064",
"telephone_number": "561-377-9760"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1508 19TH AVE N # 561",
"city": "LAKE WORTH",
"state": "FL",
"postal_code": "334606064",
"telephone_number": "561-377-9760"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GUERRA RODRIGUEZ",
"first_name": "IVELYN",
"credential": "RBT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-07-02",
"last_updated": "2021-08-26",
"certification_date": "2021-08-26",
"status": "A"
},
"taxonomies": [
{
"code": "251E00000X",
"taxonomy_group": "",
"desc": "Home Health",
"state": null,
"license": null,
"primary": false
},
{
"code": "106S00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Behavior Technician",
"state": "FL",
"license": "RBT21-159043",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "110625000",
"state": "FL"
}
],
"endpoints": [
{
"endpointType": "OTHERS",
"endpointTypeDescription": "Other URL",
"endpoint": "ivelynguerra@gmail.com",
"affiliation": "N",
"endpointDescription": "secure email",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "1508 19th Ave N # 561",
"city": "Lake Worth",
"state": "FL",
"country_code": "US",
"postal_code": "334606064",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Lake Worth, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 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.