Active NPI
Evelyn Ortiz Bacallao
- Behavior Technician
- Tampa, FL
National Provider Identifier
1588427918
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- RBT-23-302235
- Practice address
- 7815 Lakeside Blvd
Tampa, FL 33614-3368 - Phone
- (786) 858-5333
- NPI assigned
- Jan 30, 2024
- Sex
- Female
- 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 | RBT-23-302235 | FL | Primary |
Addresses
Primary practice location
7815 Lakeside Blvd
Tampa, FL 33614-3368
Mailing address
7815 Lakeside Blvd
Tampa, FL 33614-3368
Phone (786) 858-5333
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
| License | State | Type | Specialty |
|---|---|---|---|
| RBT-23-302235 | FL | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1706572800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1706572800000",
"number": "1588427918",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7815 LAKESIDE BLVD",
"city": "TAMPA",
"state": "FL",
"postal_code": "336143368",
"telephone_number": "786-858-5333"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7815 LAKESIDE BLVD",
"city": "TAMPA",
"state": "FL",
"postal_code": "336143368",
"telephone_number": "786-858-5333"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ORTIZ BACALLAO",
"first_name": "EVELYN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-01-30",
"last_updated": "2024-01-30",
"certification_date": "2024-01-30",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "FL",
"license": "RBT-23-302235",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tampa, FL
- Orthosleep LLC
- Orthostem Institute, PA
- Orthotic & Prosthetic Centers, Inc.
- Orthotic and Prosthetic Clinics of America
- Orthotic and Prosthetic Clinics of America
- Lourdes Mercedes Ortiz Badger, LPCC
- Beatriz Ortiz Bauza
- Migdalia Ortiz Iovino, NP
- Kevin Marcos Ortiz Jimenez
- Sonali Arundhati Ortiz-Casillas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 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.