Individual provider Active NPI

Lidice Mairin Fernandez Valladares

  • Behavior Technician
  • Lehigh Acres, FL
National Provider Identifier
1417826579
Registry record updated Nov 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
License
RBT-25-488127 Issued in FL
Practice address
3308 25TH St SW
Lehigh Acres, FL 33976-3951
Phone
(786) 337-1488
NPI assigned
Nov 5, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 7, 2025

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 RBT-25-488127 FL Primary

Addresses

Primary practice location

3308 25TH St SW
Lehigh Acres, FL 33976-3951

Mailing address

3308 25TH St SW
Lehigh Acres, FL 33976-3951
Phone (786) 337-1488

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

LicenseStateTypeSpecialty
RBT-25-488127FLMDBehavior Technician

NPI Registry JSON

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

{
    "created_epoch": "1762300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762473600000",
    "number": "1417826579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3308 25TH ST SW",
            "city": "LEHIGH ACRES",
            "state": "FL",
            "postal_code": "339763951",
            "telephone_number": "786-337-1488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3308 25TH ST SW",
            "city": "LEHIGH ACRES",
            "state": "FL",
            "postal_code": "339763951",
            "telephone_number": "786-337-1488"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERNANDEZ VALLADARES",
        "first_name": "LIDICE",
        "middle_name": "MAIRIN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-11-05",
        "last_updated": "2025-11-07",
        "certification_date": "2025-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "FL",
            "license": "RBT-25-488127",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lehigh Acres, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 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.

Verify at the official NPI Registry.