Active NPI
Kelly Canizales
- Behavior Technician
- Maitland, FL
National Provider Identifier
1447811773
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- Practice address
- 140 Advance PT
Maitland, FL 32751-3422 - Phone
- (386) 627-1058
- NPI assigned
- Jun 26, 2019
- 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 | FL | Primary |
Addresses
Primary practice location
140 Advance PT
Maitland, FL 32751-3422
Mailing address
163 Sterling Springs LN
Altamonte Springs, FL 32714-3856
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| C524504906340 | Other | FL | DRIVERS LICENSE |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | kcanizales@advancebehavior.com |
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": "1561507200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1561507200000",
"number": "1447811773",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "163 STERLING SPRINGS LN",
"city": "ALTAMONTE SPRINGS",
"state": "FL",
"postal_code": "327143856"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "140 ADVANCE PT",
"city": "MAITLAND",
"state": "FL",
"postal_code": "327513422",
"telephone_number": "386-627-1058"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CANIZALES",
"first_name": "KELLY",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-06-26",
"last_updated": "2019-06-26",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "FL",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DRIVERS LICENSE",
"identifier": "C524504906340",
"state": "FL"
}
],
"endpoints": [
{
"endpointType": "OTHERS",
"endpointTypeDescription": "Other URL",
"endpoint": "kcanizales@advancebehavior.com",
"affiliation": "N",
"address_1": "140 Advance Pt",
"city": "Maitland",
"state": "FL",
"country_code": "US",
"postal_code": "327513422",
"country_name": "United States",
"address_type": "DOM"
}
],
"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 Jun 26, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.