Individual provider Active NPI

Jamie Lee Bonfante

  • Behavior Technician
  • Palm City, FL
National Provider Identifier
1629797733
Registry record updated Jan 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
License
RBT-22-239300 Issued in NU
Practice address
1765 SW Captains PL
Palm City, FL 34990-1747
Phone
(772) 266-8727
NPI assigned
Aug 23, 2022
Last updated
Jan 29, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2024

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-22-239300 NU Primary

Addresses

Primary practice location

1765 SW Captains PL
Palm City, FL 34990-1747

Mailing address

6202 Wallis Rd Apt 205
West Palm Beach, FL 33413-1913
Phone (754) 217-9635

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

OrganizationSpecialtyStatusNew patients
Simplyaba, LLC CurrentSince Feb 4, 2024 Accepting new patients
My Favorite Therapists, LLC PastSince Feb 4, 2024 Accepting new patients

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, 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": "1661212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706486400000",
    "number": "1629797733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6202 WALLIS RD APT 205",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334131913",
            "telephone_number": "754-217-9635"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1765 SW CAPTAINS PL",
            "city": "PALM CITY",
            "state": "FL",
            "postal_code": "349901747",
            "telephone_number": "772-266-8727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONFANTE",
        "first_name": "JAMIE",
        "middle_name": "LEE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-23",
        "last_updated": "2024-01-29",
        "certification_date": "2024-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "NU",
            "license": "RBT-22-239300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm City, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 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.

Verify at the official NPI Registry.