Camilo De Jesus Basulto Martinez
Individual provider Active NPI Behavior Technician · Temple Terrace, FL
NPI 1497600944 · NPPES record last updated Mar 2, 2026
Key facts
- NPI
- 1497600944
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Behavior Technician 106S00000X
- Practice address
- 12911 N Telecom Pkwy
Temple Terrace, FL 33637-0907 - Phone
- (813) 553-7880
- NPI assigned
- Mar 2, 2026
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | FL | Yes |
Addresses
Primary practice location
12911 N Telecom Pkwy
Temple Terrace, FL 33637-0907
Mailing address
300 International Pkwy Ste 200
Lake Mary, FL 32746-5028
Other providers in Temple Terrace, FL
- Melanie Angelia Barriffe
- Jared Edward Barron
- Barry C Levine DMD PA
- Morgan Basler
- Tania Efigenia Bastardo
- Baws Express Medical Supplies Inc
- Jo Anne L Baxter
- Bay Area Neuro Clinic Inc
- Bay Area Restorative Therapy Services, LLC
- Baymotion Transit LLC
All providers in Temple Terrace, FL · Behavior Technician in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 2, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.