Individual provider Active NPI

Leduan Gutierrez Daniel

  • Behavior Technician
  • Tampa, FL
National Provider Identifier
1750156006
Registry record updated Nov 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
License
23296260 Issued in FL
Practice address
8001 Beaty Grove Dr
Tampa, FL 33626-1602
Phone
(813) 926-5454
NPI assigned
Nov 16, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2023

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 23296260 FL Primary

Addresses

Primary practice location

8001 Beaty Grove Dr
Tampa, FL 33626-1602

Mailing address

4419 Akita Dr
Tampa, FL 33624-1103
Phone (813) 753-6772

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
23296260FLMDBehavior Technician

NPI Registry JSON

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

{
    "created_epoch": "1700092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701302400000",
    "number": "1750156006",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4419 AKITA DR",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336241103",
            "telephone_number": "813-753-6772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8001 BEATY GROVE DR",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336261602",
            "telephone_number": "813-926-5454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUTIERREZ DANIEL",
        "first_name": "LEDUAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-11-16",
        "last_updated": "2023-11-30",
        "certification_date": "2023-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "FL",
            "license": "23296260",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 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.

Verify at the official NPI Registry.