Active NPI
Isabella Marie Preseau
- Behavior Technician
- Lithia, FL
National Provider Identifier
1649822875
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- P620413007060
- Practice address
- 5454 Lithia Pinecrest Rd
Lithia, FL 33547-2853 - Phone
- (866) 610-0580
- NPI assigned
- Jul 9, 2019
- Last updated
- Jul 15, 2019
- Sex
- Female
- Sole proprietor
- No
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 | P620413007060 | FL | Primary |
Addresses
Primary practice location
5454 Lithia Pinecrest Rd
Lithia, FL 33547-2853
Mailing address
300 International Pkwy Ste 200
Lake Mary, FL 32746-5028
Phone (813) 467-9280
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 |
|---|---|---|---|
| P620413007060 | FL | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1562630400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1563148800000",
"number": "1649822875",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "300 INTERNATIONAL PKWY STE 200",
"city": "LAKE MARY",
"state": "FL",
"postal_code": "327465028",
"telephone_number": "813-467-9280"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5454 LITHIA PINECREST RD",
"city": "LITHIA",
"state": "FL",
"postal_code": "335472853",
"telephone_number": "866-610-0580"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PRESEAU",
"first_name": "ISABELLA",
"middle_name": "MARIE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-07-09",
"last_updated": "2019-07-15",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "FL",
"license": "P620413007060",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lithia, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.