Active NPI
Martha Fernandez
- Behavior Technician
- Port Charlotte, FL
National Provider Identifier
1407462500
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- 20132469
- Practice address
- 18245 Paulson Dr Ste 104
Port Charlotte, FL 33954-1019 - Phone
- (813) 528-7048
- NPI assigned
- Sep 23, 2020
- Sex
- Female
- Sole proprietor
- No
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 | 20132469 | FL | Primary |
Addresses
Primary practice location
18245 Paulson Dr Ste 104
Port Charlotte, FL 33954-1019
Mailing address
148 NW 6TH Ave
Cape Coral, FL 33993-2430
Phone (239) 747-3873
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
| License | State | Type | Specialty |
|---|---|---|---|
| 20132469 | FL | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1600819200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1739923200000",
"number": "1407462500",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "148 NW 6TH AVE",
"city": "CAPE CORAL",
"state": "FL",
"postal_code": "339932430",
"telephone_number": "239-747-3873"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "18245 PAULSON DR STE 104",
"city": "PORT CHARLOTTE",
"state": "FL",
"postal_code": "339541019",
"telephone_number": "813-528-7048"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FERNANDEZ",
"first_name": "MARTHA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-09-23",
"last_updated": "2025-02-19",
"certification_date": "2025-02-19",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "FL",
"license": "20132469",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Port Charlotte, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 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.