Individual provider Active NPI

Jeannice Blazquez

  • Behavior Technician
  • West Park, FL
National Provider Identifier
1679401574
Registry record updated May 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
Practice address
3832 SW 33Rd CT
West Park, FL 33023-5631
Phone
(954) 947-5061
Fax
(954) 371-2510
NPI assigned
May 11, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 11, 2026

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 Primary

Addresses

Primary practice location

3832 SW 33Rd CT
West Park, FL 33023-5631

Mailing address

9941 SW Davanti Dr
Port Saint Lucie, FL 34987-6716
Phone (786) 877-4177

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": "1778457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778457600000",
    "number": "1679401574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9941 SW DAVANTI DR",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349876716",
            "telephone_number": "786-877-4177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3832 SW 33RD CT",
            "city": "WEST PARK",
            "state": "FL",
            "postal_code": "330235631",
            "telephone_number": "954-947-5061",
            "fax_number": "954-371-2510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAZQUEZ",
        "first_name": "JEANNICE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-05-11",
        "last_updated": "2026-05-11",
        "certification_date": "2026-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Park, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 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.