Active NPI
Rebeca Guerra Pernas
- Behavior Technician
- Maitland, FL
National Provider Identifier
1396258091
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- Practice address
- 414 Lake Howell Rd
Maitland, FL 32751-5900 - Phone
- (321) 317-7188
- NPI assigned
- Nov 16, 2017
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | Primary |
Addresses
Primary practice location
414 Lake Howell Rd
Maitland, FL 32751-5900
Mailing address
2208 Vincent Rd
Orlando, FL 32817-4324
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 020529700 | Medicaid | FL |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1510790400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1510790400000",
"number": "1396258091",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2208 VINCENT RD",
"city": "ORLANDO",
"state": "FL",
"postal_code": "328174324"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "414 LAKE HOWELL RD",
"city": "MAITLAND",
"state": "FL",
"postal_code": "327515900",
"telephone_number": "321-317-7188"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GUERRA PERNAS",
"first_name": "REBECA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-11-16",
"last_updated": "2017-11-16",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "020529700",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Maitland, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.