Individual provider Active NPI

Jorge E Perez Gonzalez, RBT

  • Behavior Technician
  • Apopka, FL
National Provider Identifier
1679930606
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
License
RBT-15-10829 Issued in FL
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

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
1679930606MedicaidFL

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-15-10829FLMDBehavior Technician

Practice roles

OrganizationSpecialtyStatusNew 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.

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.

Verify at the official NPI Registry.