Active NPI
Mateo Zuleta
- Behavior Technician
- Greenacres, FL
National Provider Identifier
1407497258
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- RBT-19-100786
- Practice address
- 6415 Lake Worth Rd Ste 204
Greenacres, FL 33463-2904 - Phone
- (561) 771-9561
- Fax
- (800) 766-3139
- NPI assigned
- Oct 2, 2019
- Sex
- Male
- 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 | RBT-19-100786 | FL | Primary |
Addresses
Primary practice location
6415 Lake Worth Rd Ste 204
Greenacres, FL 33463-2904
Mailing address
201 Lake Arbor Dr
Palm Springs, FL 33461-2144
Phone (561) 667-8534
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 104469100 | 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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RBT-19-100786 | FL | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1569974400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1694736000000",
"number": "1407497258",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "201 LAKE ARBOR DR",
"city": "PALM SPRINGS",
"state": "FL",
"postal_code": "334612144",
"telephone_number": "561-667-8534"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6415 LAKE WORTH RD STE 204",
"city": "GREENACRES",
"state": "FL",
"postal_code": "334632904",
"telephone_number": "561-771-9561",
"fax_number": "800-766-3139"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ZULETA",
"first_name": "MATEO",
"name_prefix": "Mr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2019-10-02",
"last_updated": "2023-09-15",
"certification_date": "2023-09-15",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "FL",
"license": "RBT-19-100786",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "104469100",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Greenacres, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 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.