Active NPI
Angelica Sofia Moreno, MD
- Behavior Technician
- Davenport, FL
National Provider Identifier
1710769427
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- RBT-23-301934
- Practice address
- 1088 Cascade Dr
Davenport, FL 33837-1600 - Phone
- (407) 765-5038
- NPI assigned
- Oct 17, 2023
- Last updated
- Oct 17, 2023
- Sex
- Female
- Sole proprietor
- No
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 | RBT-23-301934 | FL | Primary |
Addresses
Primary practice location
1088 Cascade Dr
Davenport, FL 33837-1600
Mailing address
1088 Cascade Dr
Davenport, FL 33837-1600
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
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RBT-23-301934 | FL | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1697500800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1697500800000",
"number": "1710769427",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1088 CASCADE DR",
"city": "DAVENPORT",
"state": "FL",
"postal_code": "338371600"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1088 CASCADE DR",
"city": "DAVENPORT",
"state": "FL",
"postal_code": "338371600",
"telephone_number": "407-765-5038"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MORENO",
"first_name": "ANGELICA",
"middle_name": "SOFIA",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-10-17",
"last_updated": "2023-10-17",
"certification_date": "2023-10-17",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "FL",
"license": "RBT-23-301934",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Davenport, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.