Individual provider Active NPI

Odeinys Avila Hernandez, RBT-24-338820

  • Behavior Technician
  • Lehigh Acres, FL
National Provider Identifier
1528811676
Registry record updated Apr 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
License
RBT-24-338820 Issued in FL
Practice address
4720 28TH St SW
Lehigh Acres, FL 33973-6136
Phone
(239) 691-1410
NPI assigned
Apr 9, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 9, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X RBT-24-338820 FL Primary

Addresses

Primary practice location

4720 28TH St SW
Lehigh Acres, FL 33973-6136

Mailing address

4720 28TH St SW
Lehigh Acres, FL 33973-6136

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
RBT-24-338820FLMDBehavior Technician

NPI Registry JSON

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

{
    "created_epoch": "1712620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712620800000",
    "number": "1528811676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4720 28TH ST SW",
            "city": "LEHIGH ACRES",
            "state": "FL",
            "postal_code": "339736136"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4720 28TH ST SW",
            "city": "LEHIGH ACRES",
            "state": "FL",
            "postal_code": "339736136",
            "telephone_number": "239-691-1410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AVILA HERNANDEZ",
        "first_name": "ODEINYS",
        "credential": "RBT-24-338820",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-04-09",
        "last_updated": "2024-04-09",
        "certification_date": "2024-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "FL",
            "license": "RBT-24-338820",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lehigh Acres, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 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.