Geavanya Broomfield

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

1-21-56511 Issued in FL

Practice address

5798 S Semoran Blvd
Orlando, FL 32822-4819

Phone

(407) 455-2105

NPI assigned

Aug 31, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1472601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702512000000",
    "number": "1548716376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4667 GARDENS PARK BLVD APT 1204",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328392424",
            "telephone_number": "407-455-2105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5798 S SEMORAN BLVD",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328224819",
            "telephone_number": "407-455-2105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROOMFIELD",
        "first_name": "GEAVANYA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-08-31",
        "last_updated": "2023-12-14",
        "certification_date": "2023-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2355S0801X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Speech-Language Assistant",
            "state": "FL",
            "license": "SI2508",
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "FL",
            "license": "1-21-56511",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "113378200",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SI2508",
            "identifier": "SI2508",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tiana Brooks
• Zedrick John Brooks
• Samantha Brooksby, PHARMD
• Michael J Broom, M.D.
• Desirea Tiffany Broome, PHARM.D.
• Simon Marie Benoit Brossier, PT, DPT, ATC, LAT
• Broster JD LLC
• Britney Anne Brothen, M.A., CCC-SLP
• Kayla Brotherton, PHARMD
• Edward A Brouillette, PHARM D

• Behavior Analyst in Orlando, FL
• Providers in Orlando, FL by specialty
• Behavior Analyst in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2023; 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.