Active NPI
Deborah Gutierrez Martinez
- Behavior Technician
- Kissimmee, FL
National Provider Identifier
1477219863
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- Practice address
- 3195 Santa Cruz Dr
Kissimmee, FL 34746-3525 - Phone
- (786) 454-6592
- NPI assigned
- Nov 10, 2021
- Sex
- Female
- Sole proprietor
- No
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
3195 Santa Cruz Dr
Kissimmee, FL 34746-3525
Mailing address
3195 Santa Cruz Dr
Kissimmee, FL 34746-3525
Phone (786) 454-6592
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 111950300 | Medicaid | FL |
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | 2099 | ||
| Other URL | 2099 |
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 |
|---|---|---|---|
| Allstar Kids Behavioral Services, Inc | 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
- Orlando, FL
- NPI 1437763497
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1636502400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1638057600000",
"number": "1477219863",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3195 SANTA CRUZ DR",
"city": "KISSIMMEE",
"state": "FL",
"postal_code": "347463525",
"telephone_number": "786-454-6592"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3195 SANTA CRUZ DR",
"city": "KISSIMMEE",
"state": "FL",
"postal_code": "347463525",
"telephone_number": "786-454-6592"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GUTIERREZ MARTINEZ",
"first_name": "DEBORAH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-11-10",
"last_updated": "2021-11-28",
"certification_date": "2021-11-28",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "FL",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "111950300",
"state": "FL"
}
],
"endpoints": [
{
"endpointType": "OTHERS",
"endpointTypeDescription": "Other URL",
"endpoint": "2099",
"affiliation": "N",
"address_1": "467 Lake Howell Rd Ste 205",
"city": "Maitland",
"state": "FL",
"country_code": "US",
"postal_code": "327515922",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "OTHERS",
"endpointTypeDescription": "Other URL",
"endpoint": "2099",
"affiliation": "N",
"address_1": "3195 Santa Cruz Dr",
"city": "Kissimmee",
"state": "FL",
"country_code": "US",
"postal_code": "347463525",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Kissimmee, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.