Individual provider Active NPI

Isla P Lopez

  • Behavior Technician
  • Lakeland, FL
National Provider Identifier
1295467066
Registry record updated Jun 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
License
RBT-18-63186 Issued in IN
Practice address
2020 E Edgewood Dr Apt 47
Lakeland, FL 33803-3644
Phone
(260) 249-9231
NPI assigned
Jun 29, 2022
Last updated
Jun 29, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2022

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-18-63186 IN Primary

Addresses

Primary practice location

2020 E Edgewood Dr Apt 47
Lakeland, FL 33803-3644

Mailing address

2020 E Edgewood Dr Apt 47
Lakeland, FL 33803-3644
Phone (260) 249-9231

Other identifiers 1

IdentifierTypeStateIssuer
9638057033MedicaidFL

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-18-63186INMDBehavior Technician

NPI Registry JSON

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

{
    "created_epoch": "1656460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656460800000",
    "number": "1295467066",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2020 E EDGEWOOD DR APT 47",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338033644",
            "telephone_number": "260-249-9231"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2020 E EDGEWOOD DR APT 47",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338033644",
            "telephone_number": "260-249-9231"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOPEZ",
        "first_name": "ISLA",
        "middle_name": "P",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-29",
        "last_updated": "2022-06-29",
        "certification_date": "2022-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "IN",
            "license": "RBT-18-63186",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9638057033",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakeland, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 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.