Individual provider Active NPI

Elizabeth De la Caridad Licea Fornaris

  • Behavior Technician
  • Fort Myers, FL
National Provider Identifier
1386553618
Registry record updated Sep 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
Practice address
3722 Central Ave Ste 6
Fort Myers, FL 33901-8247
Phone
(239) 848-5560
Fax
(855) 521-0661
NPI assigned
Sep 2, 2026
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 2, 2026

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 Primary

Addresses

Primary practice location

3722 Central Ave Ste 6
Fort Myers, FL 33901-8247

Mailing address

1010 Ridgeway Dr
North Fort Myers, FL 33903-4244
Phone (239) 309-3367

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI Registry JSON

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

{
    "created_epoch": "1788307200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788307200000",
    "number": "1386553618",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1010 RIDGEWAY DR",
            "city": "NORTH FORT MYERS",
            "state": "FL",
            "postal_code": "339034244",
            "telephone_number": "239-309-3367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3722 CENTRAL AVE STE 6",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339018247",
            "telephone_number": "239-848-5560",
            "fax_number": "855-521-0661"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LICEA FORNARIS",
        "first_name": "ELIZABETH",
        "middle_name": "DE LA CARIDAD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-09-02",
        "last_updated": "2026-09-02",
        "certification_date": "2026-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Myers, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.