NPIMap

Organization Active NPI

Pelican of Wellness

  • Behavior Analyst
  • Oakland Park, FL
National Provider Identifier
1386965077
Registry record updated Aug 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Legal business name
PELICAN OF WELLNESS
Practice address
2701 W Oakland Park Blvd
Oakland Park, FL 33311-1388
Phone
(954) 987-3201
NPI assigned
Jun 16, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2023

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

Authorized official

Name
Mr. Orville Anthony Lyttle, MASTERNPI 1013348176
Title
Bcba
Phone
(954) 987-3201

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior AnalystGroup: 193400000X SINGLE SPECIALTY GROUP 103K00000X Primary

Addresses

Primary practice location

2701 W Oakland Park Blvd
Oakland Park, FL 33311-1388

Mailing address

2701 W Oakland Park Blvd
Oakland Park, FL 33311-1388
Phone (954) 987-3201

National Provider Directory

National Provider Directory
Tax ID family
Pelican of Wellness2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1276646400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1692489600000",
    "number": "1386965077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2701 W OAKLAND PARK BLVD",
            "city": "OAKLAND PARK",
            "state": "FL",
            "postal_code": "333111388",
            "telephone_number": "954-987-3201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2701 W OAKLAND PARK BLVD",
            "city": "OAKLAND PARK",
            "state": "FL",
            "postal_code": "333111388",
            "telephone_number": "954-987-3201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PELICAN OF WELLNESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-06-16",
        "last_updated": "2023-08-20",
        "certification_date": "2023-08-20",
        "status": "A",
        "authorized_official_last_name": "LYTTLE",
        "authorized_official_first_name": "ORVILLE",
        "authorized_official_middle_name": "ANTHONY",
        "authorized_official_title_or_position": "BCBA",
        "authorized_official_telephone_number": "954-987-3201",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MASTER"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakland Park, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 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.