Active NPI
Jorge E Perez Gonzalez, RBT
- Behavior Technician
- Apopka, FL
National Provider Identifier
1679930606
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- RBT-15-10829
- Practice address
- 1518 Stoneywood Way
Apopka, FL 32712-1912 - Phone
- (407) 212-1199
- NPI assigned
- Jan 21, 2016
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | FL | ||
| Behavior Technician | 106S00000X | RBT-15-10829 | FL | Primary |
Addresses
Primary practice location
1518 Stoneywood Way
Apopka, FL 32712-1912
Mailing address
3537 Peppervine Dr
Orlando, FL 32828-4859
Phone (336) 554-1289
Other practice location 1
500 Fairway Dr Ste 102
Deerfield Beach, FL 33441-1817
Phone (954) 603-7885
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679930606 | Medicaid | FL |
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 |
|---|---|---|---|
| RBT-15-10829 | FL | MD | Behavior Technician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Accelerate Behavioral Health, LLC | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Behavior Analyst
- Orlando, FL
- NPI 1194260497
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1453334400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1679930606",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3537 PEPPERVINE DR",
"city": "ORLANDO",
"state": "FL",
"postal_code": "328284859",
"telephone_number": "336-554-1289"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1518 STONEYWOOD WAY",
"city": "APOPKA",
"state": "FL",
"postal_code": "327121912",
"telephone_number": "407-212-1199"
}
],
"practiceLocations": [
{
"address_1": "500 Fairway Dr Ste 102",
"address_purpose": "LOCATION",
"city": "Deerfield Beach",
"state": "FL",
"postal_code": "334411817",
"country_code": "US",
"telephone_number": "954-603-7885",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "PEREZ GONZALEZ",
"first_name": "JORGE",
"middle_name": "E",
"credential": "RBT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-01-21",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "FL",
"license": null,
"primary": false
},
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "FL",
"license": "RBT-15-10829",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1679930606",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Apopka, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.