Individual provider Active NPI

Leanet Diaz Rivero, RBT

  • Behavior Technician
  • Port Saint Lucie, FL
National Provider Identifier
1336956374
Registry record updated Dec 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
License
RBT-24-395565 Issued in FL
Practice address
654 SW Backert Ave
Port Saint Lucie, FL 34953-5560
Phone
(786) 458-2750
NPI assigned
Dec 13, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 13, 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-24-395565 FL Primary

Addresses

Primary practice location

654 SW Backert Ave
Port Saint Lucie, FL 34953-5560

Mailing address

654 SW Backert Ave
Port Saint Lucie, FL 34953-5560
Phone (786) 458-2750

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-24-395565FLMDBehavior Technician

NPI Registry JSON

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

{
    "created_epoch": "1734048000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734048000000",
    "number": "1336956374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "654 SW BACKERT AVE",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349535560",
            "telephone_number": "786-458-2750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "654 SW BACKERT AVE",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349535560",
            "telephone_number": "786-458-2750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIAZ RIVERO",
        "first_name": "LEANET",
        "credential": "RBT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-12-13",
        "last_updated": "2024-12-13",
        "certification_date": "2024-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "FL",
            "license": "RBT-24-395565",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Saint Lucie, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 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.