Individual provider Active NPI

Lisandra Taimy Vigoa Diaz

  • Behavior Technician
  • Kissimmee, FL
National Provider Identifier
1679254502
Registry record updated Jul 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
License
RBT-23-286730 Issued in FL
Practice address
812 Country Crossing CT
Kissimmee, FL 34744-4638
Phone
(407) 283-2796
NPI assigned
Jul 25, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 25, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior TechnicianGroup: 193400000X SINGLE SPECIALTY GROUP 106S00000X RBT-23-286730 FL Primary

Addresses

Primary practice location

812 Country Crossing CT
Kissimmee, FL 34744-4638

Mailing address

812 Country Crossing CT
Kissimmee, FL 34744-4638
Phone (407) 283-2796

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-23-286730FLMDBehavior Technician

NPI Registry JSON

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

{
    "created_epoch": "1690243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690243200000",
    "number": "1679254502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "812 COUNTRY CROSSING CT",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347444638",
            "telephone_number": "407-283-2796"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "812 COUNTRY CROSSING CT",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347444638",
            "telephone_number": "407-283-2796"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VIGOA DIAZ",
        "first_name": "LISANDRA",
        "middle_name": "TAIMY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-07-25",
        "last_updated": "2023-07-25",
        "certification_date": "2023-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Behavior Technician",
            "state": "FL",
            "license": "RBT-23-286730",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kissimmee, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2023; 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.