Antonella Stama

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

License

RBT-22-224418 Issued in FL

Practice address

455 S Kennel St
Clewiston, FL 33440

Phone

(305) 282-3530

NPI assigned

Sep 7, 2022

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1662508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662508800000",
    "number": "1295456333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "455 S KENNEL ST",
            "city": "CLEWISTON",
            "state": "FL",
            "postal_code": "33440",
            "telephone_number": "305-282-3530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "455 S KENNEL ST",
            "city": "CLEWISTON",
            "state": "FL",
            "postal_code": "33440",
            "telephone_number": "305-282-3530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STAMA",
        "first_name": "ANTONELLA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-09-07",
        "last_updated": "2022-09-07",
        "certification_date": "2022-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "FL",
            "license": "RBT-22-224418",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RBT",
            "identifier": "RBT-22-224418",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "address",
            "affiliation": "N",
            "address_1": "455 S KENNEL ST",
            "city": "CLEWISTON",
            "state": "FL",
            "country_code": "US",
            "postal_code": "33440",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Behavior Technician in Clewiston, FL
• Providers in Clewiston, FL by specialty
• Behavior Technician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 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.

Verify at the official NPI Registry.