Individual provider Active NPI

Melissa Maura Moran Gonzalez

  • Behavior Technician
  • Lake Worth Beach, FL
National Provider Identifier
1265288948
Registry record updated Apr 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
License
RBT-24-341266 Issued in FL
Practice address
1716 Pierce Dr
Lake Worth Beach, FL 33460-6042
Phone
(561) 313-9019
NPI assigned
Apr 24, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 24, 2024

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 RBT-24-341266 FL Primary

Addresses

Primary practice location

1716 Pierce Dr
Lake Worth Beach, FL 33460-6042

Mailing address

1716 Pierce Dr
Lake Worth Beach, FL 33460-6042
Phone (561) 313-9019

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-24-341266FLMDBehavior Technician

NPI Registry JSON

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

{
    "created_epoch": "1713916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713916800000",
    "number": "1265288948",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1716 PIERCE DR",
            "city": "LAKE WORTH BEACH",
            "state": "FL",
            "postal_code": "334606042",
            "telephone_number": "561-313-9019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1716 PIERCE DR",
            "city": "LAKE WORTH BEACH",
            "state": "FL",
            "postal_code": "334606042",
            "telephone_number": "561-313-9019"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORAN GONZALEZ",
        "first_name": "MELISSA",
        "middle_name": "MAURA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-04-24",
        "last_updated": "2024-04-24",
        "certification_date": "2024-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "FL",
            "license": "RBT-24-341266",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Worth Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2024; 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.