Active NPI
Rena Larette Tillman, MBA
- Behavior Technician
- Sanford, FL
National Provider Identifier
1306162516
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- 21-177750
- Practice address
- 1620 Roundtree Ave
Sanford, FL 32771-3262 - Phone
- (407) 314-2374
- NPI assigned
- Apr 13, 2010
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | 21-177750 | FL | Primary |
Addresses
Primary practice location
1620 Roundtree Ave
Sanford, FL 32771-3262
Mailing address
125 Hartsdale Dr
Winter Garden, FL 34787-6057
Phone (407) 314-2374
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1 | Other | FL | RENA TILLMAN |
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
- Credentials
- Master of Business Administration
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1271116800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1787616000000",
"number": "1306162516",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "125 HARTSDALE DR",
"city": "WINTER GARDEN",
"state": "FL",
"postal_code": "347876057",
"telephone_number": "407-314-2374"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1620 ROUNDTREE AVE",
"city": "SANFORD",
"state": "FL",
"postal_code": "327713262",
"telephone_number": "407-314-2374"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TILLMAN",
"first_name": "RENA",
"middle_name": "LARETTE",
"credential": "MBA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-04-13",
"last_updated": "2026-08-25",
"certification_date": "2026-08-25",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "FL",
"license": "21-177750",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RENA TILLMAN",
"identifier": "1",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Sanford, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.