Active NPI
Carlos Ernesto De Avila de la Fuente
- Behavior Technician
- Orlando, FL
National Provider Identifier
1558042598
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- Practice address
- 2151 Consulate Dr Ste 11
Orlando, FL 32837-8806 - Phone
- (321) 444-9527
- NPI assigned
- Jul 31, 2023
- Sex
- Male
- Sole proprietor
- Yes
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 | Primary |
Addresses
Primary practice location
2151 Consulate Dr Ste 11
Orlando, FL 32837-8806
Mailing address
2151 Consulate Dr Ste 11
Orlando, FL 32837-8806
Phone (321) 444-9527
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 |
|---|---|---|---|
| Side by Side Behavioral Health LLC | Behavior Technician | Current | Accepting new patients |
| Side by Side Behavioral Health LLC | Behavior Technician | Current | Accepting new patients |
Locations
2151 Consulate Dr
Ste 11
Orlando, FL 32837
Phone (321) 444-9527
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": "1690761600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1690761600000",
"number": "1558042598",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2151 CONSULATE DR STE 11",
"city": "ORLANDO",
"state": "FL",
"postal_code": "328378806",
"telephone_number": "321-444-9527"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2151 CONSULATE DR STE 11",
"city": "ORLANDO",
"state": "FL",
"postal_code": "328378806",
"telephone_number": "321-444-9527"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DE AVILA DE LA FUENTE",
"first_name": "CARLOS",
"middle_name": "ERNESTO",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2023-07-31",
"last_updated": "2023-07-31",
"certification_date": "2023-07-31",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Orlando, FL
- Katherine Elizabeth De Anda-Oquendo
- Vania C De Andrade, APRN
- Iglenis De Armas Oquendo
- Yarianna De Armas Pillado
- Crislainy Kety De Arruda Swaner
- Justin Adam De Boer, M.D.
- Elaine De Carvalho Macedo, APRN
- Ana Carolina De Carvalho Sabate Carmona, PT
- Sheila Mara De Carvalho, SLPA
- Michelle De Castro Figueroa
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 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.