Active NPI
Amanda Alicia Rivera
- Behavior Technician
- Casselberry, FL
National Provider Identifier
1699279406
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- Practice address
- 148 Wilshire Blvd Ste 148
Casselberry, FL 32707-5372 - Phone
- (321) 972-4039
- NPI assigned
- Mar 19, 2018
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | Primary |
Addresses
Primary practice location
148 Wilshire Blvd Ste 148
Casselberry, FL 32707-5372
Mailing address
1130 Meadow Lake Way Apt 206
Winter Springs, FL 32708-5279
Phone (646) 659-1818
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0000 | 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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1521417600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1546560000000",
"number": "1699279406",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1130 MEADOW LAKE WAY APT 206",
"city": "WINTER SPRINGS",
"state": "FL",
"postal_code": "327085279",
"telephone_number": "646-659-1818"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "148 WILSHIRE BLVD STE 148",
"city": "CASSELBERRY",
"state": "FL",
"postal_code": "327075372",
"telephone_number": "321-972-4039"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RIVERA",
"first_name": "AMANDA",
"middle_name": "ALICIA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-03-19",
"last_updated": "2019-01-04",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Behavior Technician",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0000",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Casselberry, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.