Active NPI
Marjoris Diaz Perez
- Behavior Technician
- Fort Myers, FL
National Provider Identifier
1417877002
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- RBT-25-459500
- Practice address
- 11503 Canopy Loop
Fort Myers, FL 33913-9457 - Phone
- (305) 917-3169
- Fax
- (888) 441-6806
- NPI assigned
- Jul 15, 2026
- 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 | RBT-25-459500 | FL | Primary |
Addresses
Primary practice location
11503 Canopy Loop
Fort Myers, FL 33913-9457
Mailing address
4410 29TH St SW
Lehigh Acres, FL 33973-6155
Phone (305) 917-3169
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Maximum Potential LLC | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Behavior Analyst
- Fort Myers, FL
- NPI 1972060762
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1784073600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1784073600000",
"number": "1417877002",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4410 29TH ST SW",
"city": "LEHIGH ACRES",
"state": "FL",
"postal_code": "339736155",
"telephone_number": "305-917-3169",
"fax_number": "888-441-6806"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11503 CANOPY LOOP",
"city": "FORT MYERS",
"state": "FL",
"postal_code": "339139457",
"telephone_number": "305-917-3169",
"fax_number": "888-441-6806"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DIAZ PEREZ",
"first_name": "MARJORIS",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2026-07-15",
"last_updated": "2026-07-15",
"certification_date": "2026-07-16",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "FL",
"license": "RBT-25-459500",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Myers, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.