Individual provider Active NPI

Ernesto Daniel Dominguez Martinez, BCBA

  • Behavior Analyst
  • Tampa, FL
National Provider Identifier
1619715216
Registry record updated Jun 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1-26-90667 Issued in FL
Practice address
304 Jeanal PL
Tampa, FL 33612-4101
Phone
(813) 400-7114
NPI assigned
Jul 17, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X 1-26-90667 FL Primary

Addresses

Primary practice location

304 Jeanal PL
Tampa, FL 33612-4101

Mailing address

304 Jeanal PL
Tampa, FL 33612-4101

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

NPI Registry JSON

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

{
    "created_epoch": "1721174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782259200000",
    "number": "1619715216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "304 JEANAL PL",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336124101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "304 JEANAL PL",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336124101",
            "telephone_number": "813-400-7114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOMINGUEZ MARTINEZ",
        "first_name": "ERNESTO",
        "middle_name": "DANIEL",
        "credential": "BCBA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-07-17",
        "last_updated": "2026-06-24",
        "certification_date": "2026-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "FL",
            "license": "1-26-90667",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2026; 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.