Individual provider Active NPI

Marcos Alejandro Villoch Fernandez

  • Behavior Technician
  • Kissimmee, FL
National Provider Identifier
1346005071
Registry record updated Feb 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
License
RBT-24-326454 Issued in FL
Practice address
159 Columbia Dr. Poinciana.
Polk County
Kissimmee, FL 34759
Phone
(407) 723-2505
NPI assigned
Feb 21, 2024
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 21, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior TechnicianGroup: 193400000X SINGLE SPECIALTY GROUP 106S00000X RBT-24-326454 FL Primary

Addresses

Primary practice location

159 Columbia Dr. Poinciana.
Polk County
Kissimmee, FL 34759

Mailing address

159 Columbia Dr. Poinciana.
Polk County
Kissimmee, FL 34759
Phone (407) 723-2505

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-24-326454FLMDBehavior Technician

NPI Registry JSON

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

{
    "created_epoch": "1708473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708473600000",
    "number": "1346005071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "159 COLUMBIA DR. POINCIANA.",
            "address_2": "POLK COUNTY",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "34759",
            "telephone_number": "407-723-2505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "159 COLUMBIA DR. POINCIANA.",
            "address_2": "POLK COUNTY",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "34759",
            "telephone_number": "407-723-2505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VILLOCH FERNANDEZ",
        "first_name": "MARCOS",
        "middle_name": "ALEJANDRO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-02-21",
        "last_updated": "2024-02-21",
        "certification_date": "2024-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Behavior Technician",
            "state": "FL",
            "license": "RBT-24-326454",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kissimmee, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 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.