Individual provider Active NPI

Susana Izquierdo, RBT

  • Behavior Technician
  • Fort Myers, FL
National Provider Identifier
1457127482
Registry record updated Jan 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
License
BACB1021239 Issued in FL
Practice address
8359 Beacon Blvd Ste 416
Fort Myers, FL 33907-3065
Phone
(571) 236-1252
NPI assigned
Nov 30, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 22, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior TechnicianGroup: 193400000X SINGLE SPECIALTY GROUP 106S00000X BACB1021239 FL Primary

Addresses

Primary practice location

8359 Beacon Blvd Ste 416
Fort Myers, FL 33907-3065

Mailing address

16 Tropicana Pkwy E
Cape Coral, FL 33909-1940
Phone (571) 236-1252

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
BACB1021239FLMDBehavior Technician

Practice roles

OrganizationSpecialtyStatusNew patients
Susana Izquierdo Therapy Solutions, LLC Behavior Technician CurrentSince Dec 1, 2023 Accepting new patients
Bright Future With ABA LLC Past Accepting new patients

Locations

8359 Beacon Blvd
Ste 416
Fort Myers, FL 33907
Phone (239) 529-0957

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1701302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705881600000",
    "number": "1457127482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 TROPICANA PKWY E",
            "city": "CAPE CORAL",
            "state": "FL",
            "postal_code": "339091940",
            "telephone_number": "571-236-1252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8359 BEACON BLVD STE 416",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339073065",
            "telephone_number": "571-236-1252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IZQUIERDO",
        "first_name": "SUSANA",
        "credential": "RBT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-11-30",
        "last_updated": "2024-01-22",
        "certification_date": "2024-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Behavior Technician",
            "state": "FL",
            "license": "BACB1021239",
            "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 Jan 22, 2024; 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.