Individual provider Active NPI

Mirielys Perez Gutierrez

  • Behavior Technician
  • Fort Myers, FL
National Provider Identifier
1689455578
Registry record updated Sep 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
Practice address
9160 Forum Corporate Pkwy Ste 350
Fort Myers, FL 33905-7808
Phone
(402) 270-1795
NPI assigned
Oct 9, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 10, 2025

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 NE Primary

Addresses

Primary practice location

9160 Forum Corporate Pkwy Ste 350
Fort Myers, FL 33905-7808

Mailing address

1205 NE 18TH Ter
Cape Coral, FL 33909-8911
Phone (402) 270-1795

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": "1696809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757462400000",
    "number": "1689455578",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1205 NE 18TH TER",
            "city": "CAPE CORAL",
            "state": "FL",
            "postal_code": "339098911",
            "telephone_number": "402-270-1795"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9160 FORUM CORPORATE PKWY STE 350",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339057808",
            "telephone_number": "402-270-1795"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEREZ GUTIERREZ",
        "first_name": "MIRIELYS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-10-09",
        "last_updated": "2025-09-10",
        "certification_date": "2025-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "NE",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Myers, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2025; 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.