NPIMap

Individual provider Active NPI

Jazzmyn Mijic, M.S. BCBA

  • Behavior Analyst
  • Winter Park, FL
National Provider Identifier
1720489131
Registry record updated Mar 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1-15-20590 Issued in FL
Practice address
2911 Stone Glen Way Apt 107
Winter Park, FL 32792-1784
Phone
(407) 780-0177
NPI assigned
Sep 5, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 21, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X 1-15-20590 FL Primary
Other Technician 247200000X

Addresses

Primary practice location

2911 Stone Glen Way Apt 107
Winter Park, FL 32792-1784

Mailing address

2911 Stone Glen Way Apt 107
Winter Park, FL 32792-1784
Phone (407) 780-0177

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
Master of Science

Practice roles

OrganizationSpecialtyStatusNew patients
Alterare Advantage LLC Behavior Analyst Current Accepting new patients
Arium Behavior Services Current Accepting new patients
Kids Therapy Services Past Accepting new patients

Organizations & group practices 3

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": "1409875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742515200000",
    "number": "1720489131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2911 STONE GLEN WAY APT 107",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327921784",
            "telephone_number": "407-780-0177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2911 STONE GLEN WAY APT 107",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327921784",
            "telephone_number": "407-780-0177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIJIC",
        "first_name": "JAZZMYN",
        "credential": "M.S. BCBA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-09-05",
        "last_updated": "2025-03-21",
        "certification_date": "2025-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "FL",
            "license": "1-15-20590",
            "primary": true
        },
        {
            "code": "247200000X",
            "taxonomy_group": "",
            "desc": "Technician, Other",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winter Park, FL

Sources for this page

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