Active NPI
Adrian Fernandez Gonzalez
- Behavior Technician
- Lake Worth, FL
National Provider Identifier
1255072203
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- RBT-22-209546
- Practice address
- 4352 Cambridge St
Lake Worth, FL 33461-2715 - Phone
- (561) 502-3740
- NPI assigned
- Apr 5, 2022
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | RBT-22-209546 | NV | Primary |
Addresses
Primary practice location
4352 Cambridge St
Lake Worth, FL 33461-2715
Mailing address
4352 Cambridge St
Lake Worth, FL 33461-2715
Phone (561) 502-3740
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 |
|---|---|---|---|
| RBT-22-209546 | NV | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1649116800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1649116800000",
"number": "1255072203",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4352 CAMBRIDGE ST",
"city": "LAKE WORTH",
"state": "FL",
"postal_code": "334612715",
"telephone_number": "561-502-3740"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4352 CAMBRIDGE ST",
"city": "LAKE WORTH",
"state": "FL",
"postal_code": "334612715",
"telephone_number": "561-502-3740"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FERNANDEZ GONZALEZ",
"first_name": "ADRIAN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2022-04-05",
"last_updated": "2022-04-05",
"certification_date": "2022-04-04",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Behavior Technician",
"state": "NV",
"license": "RBT-22-209546",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"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 Apr 5, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.