Individual provider Active NPI

Marisabel De la Caridad Olivera

  • Behavior Technician
  • Brandon, FL
National Provider Identifier
1366121774
Registry record updated Jul 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
License
23-283228 Issued in FL
Practice address
902 W Lumsden Rd
Brandon, FL 33511-8806
Phone
(813) 607-8237
NPI assigned
Jul 13, 2023
Last updated
Jul 13, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 13, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X 23-283228 FL Primary
Behavior Technician 106S00000X NU

Addresses

Primary practice location

902 W Lumsden Rd
Brandon, FL 33511-8806

Mailing address

8721 N Boulevard
Tampa, FL 33604-1206

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
23-283228FLMDBehavior Technician

NPI Registry JSON

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

{
    "created_epoch": "1689206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689206400000",
    "number": "1366121774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8721 N BOULEVARD",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336041206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "902 W LUMSDEN RD",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335118806",
            "telephone_number": "813-607-8237"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLIVERA",
        "first_name": "MARISABEL",
        "middle_name": "DE LA CARIDAD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-07-13",
        "last_updated": "2023-07-13",
        "certification_date": "2023-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "FL",
            "license": "23-283228",
            "primary": true
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brandon, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2023; 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.