Individual provider Active NPI

Natalia Eloisa Mendez Diaz

  • Behavior Technician
  • Lehigh Acres, FL
National Provider Identifier
1265205934
Registry record updated Nov 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
License
BACB992808 Issued in FL
Practice address
130 Lee Blvd Ste 2
Lehigh Acres, FL 33936-6120
Phone
(239) 674-9310
NPI assigned
Nov 3, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 3, 2023

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 BACB992808 FL Primary

Addresses

Primary practice location

130 Lee Blvd Ste 2
Lehigh Acres, FL 33936-6120

Mailing address

172 Ridgemont Dr
Lehigh Acres, FL 33972-1038
Phone (786) 308-0744

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
BACB992808FLMDBehavior Technician

Practice roles

OrganizationSpecialtyStatusNew patients
Palomo Health Care CurrentSince Nov 5, 2023 Accepting new patients

Locations

130 Lee Blvd
Ste 2
Lehigh Acres, FL 33936
Phone (239) 674-9310

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": "1698969600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698969600000",
    "number": "1265205934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "172 RIDGEMONT DR",
            "city": "LEHIGH ACRES",
            "state": "FL",
            "postal_code": "339721038",
            "telephone_number": "786-308-0744"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 LEE BLVD STE 2",
            "city": "LEHIGH ACRES",
            "state": "FL",
            "postal_code": "339366120",
            "telephone_number": "239-674-9310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENDEZ DIAZ",
        "first_name": "NATALIA",
        "middle_name": "ELOISA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-11-03",
        "last_updated": "2023-11-03",
        "certification_date": "2023-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "FL",
            "license": "BACB992808",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lehigh Acres, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2023; 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.