Individual provider Active NPI

Luz Mojica

  • Behavior Analyst
  • Fort Myers, FL
National Provider Identifier
1265919427
Registry record updated Jul 20, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
455111407 Issued in FL
Practice address
8359 Beacon Blvd Ste 416
Fort Myers, FL 33907-3065
Phone
(347) 731-2348
NPI assigned
Jul 20, 2018
Last updated
Jul 20, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X 455111407 FL Primary

Addresses

Primary practice location

8359 Beacon Blvd Ste 416
Fort Myers, FL 33907-3065

Mailing address

5519 Legacy Crescent PL Unit 301
Riverview, FL 33578-2809
Phone (856) 361-4605

Other identifiers 1

IdentifierTypeStateIssuer
455111407MedicaidFL

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
455111407FLMDBehavioral Analyst

NPI Registry JSON

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

{
    "created_epoch": "1532044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532044800000",
    "number": "1265919427",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5519 LEGACY CRESCENT PL UNIT 301",
            "city": "RIVERVIEW",
            "state": "FL",
            "postal_code": "335782809",
            "telephone_number": "856-361-4605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8359 BEACON BLVD STE 416",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339073065",
            "telephone_number": "347-731-2348"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOJICA",
        "first_name": "LUZ",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-20",
        "last_updated": "2018-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "FL",
            "license": "455111407",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "455111407",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Myers, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2018; 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.