Individual provider Active NPI

Rosali Costas

  • Behavior Technician
  • Fort Myers, FL
National Provider Identifier
1588210413
Registry record updated Nov 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
License
RBT-18-66164 Issued in FL
Practice address
1500 Colonial Blvd Ste 102
Fort Myers, FL 33907-1025
Phone
(239) 294-0901
NPI assigned
Aug 15, 2019
Last updated
Nov 17, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 17, 2022

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-18-66164 FL Primary

Addresses

Primary practice location

1500 Colonial Blvd Ste 102
Fort Myers, FL 33907-1025

Mailing address

3163 W 78TH PL
Hialeah, FL 33018-3848
Phone (786) 458-3113

Other practice location 1

3163 W 78th Pl
Hialeah, FL 33018-3848
Phone (786) 468-3113

Other practice location 2

730 SW 4th St Ste 6
Cape Coral, FL 33991-1984
Phone (239) 910-0712

Other identifiers 1

IdentifierTypeStateIssuer
020729300MedicaidFL

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-18-66164FLMDBehavior Technician

Practice roles

OrganizationSpecialtyStatusNew patients
Family Initiative Incorporated CurrentSince Mar 1, 2022 Accepting new patients

Locations

730 SW 4th St
Ste 6
Cape Coral, FL 33991
Phone (239) 910-0712

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1565827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668643200000",
    "number": "1588210413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3163 W 78TH PL",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330183848",
            "telephone_number": "786-458-3113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 COLONIAL BLVD STE 102",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339071025",
            "telephone_number": "239-294-0901"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3163 W 78th Pl",
            "address_purpose": "LOCATION",
            "city": "Hialeah",
            "state": "FL",
            "postal_code": "330183848",
            "country_code": "US",
            "telephone_number": "786-468-3113",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "730 SW 4th St Ste 6",
            "address_purpose": "LOCATION",
            "city": "Cape Coral",
            "state": "FL",
            "postal_code": "339911984",
            "country_code": "US",
            "telephone_number": "239-910-0712",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COSTAS",
        "first_name": "ROSALI",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-08-15",
        "last_updated": "2022-11-17",
        "certification_date": "2022-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "FL",
            "license": "RBT-18-66164",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "020729300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Myers, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2022; 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.