Individual provider Active NPI

Adrian J. Medina Perez, RBT

  • Behavior Technician
  • Port St Lucie, FL
National Provider Identifier
1710854096
Registry record updated Oct 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
License
RBT-25-476988 Issued in FL
Practice address
1401 SE Goldtree Dr Ste 101
Port St Lucie, FL 34952-7584
Phone
(772) 212-7539
Fax
(772) 673-8392
NPI assigned
Oct 21, 2025
Last updated
Oct 21, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 21, 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 RBT-25-476988 FL Primary

Addresses

Primary practice location

1401 SE Goldtree Dr Ste 101
Port St Lucie, FL 34952-7584

Mailing address

2142 SE Holland St
Port St Lucie, FL 34952-4828
Phone (682) 556-8109

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-25-476988FLMDBehavior Technician

Practice roles

OrganizationSpecialtyStatusNew patients
Let's DO ABA LLC CurrentSince Nov 7, 2025 Accepting new patients

Locations

1401 SE Goldtree Dr
Ste 101
Port St Lucie, FL 34952
Phone (772) 212-7539

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1761004800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761004800000",
    "number": "1710854096",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2142 SE HOLLAND ST",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349524828",
            "telephone_number": "682-556-8109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 SE GOLDTREE DR STE 101",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349527584",
            "telephone_number": "772-212-7539",
            "fax_number": "772-673-8392"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEDINA PEREZ",
        "first_name": "ADRIAN",
        "middle_name": "J.",
        "credential": "RBT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-10-21",
        "last_updated": "2025-10-21",
        "certification_date": "2025-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "FL",
            "license": "RBT-25-476988",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port St Lucie, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 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.