Individual provider Active NPI

Andromina Bergues

  • Behavior Technician
  • Lehigh Acres, FL
National Provider Identifier
1366097743
Registry record updated Feb 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
License
RBT-18-60854 Issued in FL
Practice address
907 Willow Dr
Lehigh Acres, FL 33936-6764
Phone
(239) 878-5877
NPI assigned
Aug 2, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 24, 2025

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-18-60854 FL Primary

Addresses

Primary practice location

907 Willow Dr
Lehigh Acres, FL 33936-6764

Mailing address

907 Willow Dr
Lehigh Acres, FL 33936-6764
Phone (239) 878-5877

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-18-60854FLMDBehavior Technician

NPI Registry JSON

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

{
    "created_epoch": "1564704000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740355200000",
    "number": "1366097743",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "907 WILLOW DR",
            "city": "LEHIGH ACRES",
            "state": "FL",
            "postal_code": "339366764",
            "telephone_number": "239-878-5877"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "907 WILLOW DR",
            "city": "LEHIGH ACRES",
            "state": "FL",
            "postal_code": "339366764",
            "telephone_number": "239-878-5877"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERGUES",
        "first_name": "ANDROMINA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-08-02",
        "last_updated": "2025-02-24",
        "certification_date": "2025-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Behavior Technician",
            "state": "FL",
            "license": "RBT-18-60854",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lehigh Acres, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2025; 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.