The Jericho Autism Center, Inc.

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

Legal business name

THE JERICHO AUTISM CENTER, INC.

Practice address

1351 Sprinkle Dr
Jacksonville, FL 32211-5448

Phone

(905) 744-5110

Fax

(904) 744-3443

NPI assigned

Apr 27, 2021

Last updated

Apr 27, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Angelo MartinezNPI 1619285954

Title

Executive Director

Phone

(904) 744-5110

Specialties & licenses 1

Addresses

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Angelo Martinez, B.C.A.B.A.

  • Behavior Analyst
  • Jacksonville, FL
  • NPI 1619285954
  NPD Authorized official
• Kalyn Bennett

  • Behavior Analyst
  • Jacksonville, FL
  • NPI 1104312347
  NPD (past)
• Olivia Hernandez

  • Behavior Analyst
  • Jacksonville, FL
  • NPI 1366083743
  NPD (past)

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

{
    "created_epoch": "1619481600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1619481600000",
    "number": "1740862994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1351 SPRINKLE DR",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322115448",
            "telephone_number": "905-744-5110",
            "fax_number": "904-744-3443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1351 SPRINKLE DR",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322115448",
            "telephone_number": "905-744-5110",
            "fax_number": "904-744-3443"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE JERICHO AUTISM CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-27",
        "last_updated": "2021-04-27",
        "certification_date": "2021-04-27",
        "status": "A",
        "authorized_official_last_name": "MARTINEZ",
        "authorized_official_first_name": "ANGELO",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "904-744-5110",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• The Jericho School for Children With Autism, Inc.
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• The Lasik Vision Institute, LLC
• The Living Fig, LLC
• The LJB Group, LLC

• Behavior Analyst in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Behavior Analyst in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2021; 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.