Individual provider Active NPI

Justin Roberto Padilla Fernandez

  • Behavior Technician
  • Port St Lucie, FL
National Provider Identifier
1750247953
Registry record updated Dec 31, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
License
RBT-25-497995 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
Dec 31, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 31, 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-25-497995 FL Primary

Addresses

Primary practice location

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

Mailing address

1533 SW del Rio Blvd
Port St Lucie, FL 34953-1452
Phone (772) 342-5500

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-25-497995FLMDBehavior Technician

Practice roles

OrganizationSpecialtyStatusNew patients
Let's DO ABA LLC CurrentSince Jan 4, 2026 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1767139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767139200000",
    "number": "1750247953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1533 SW DEL RIO BLVD",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349531452",
            "telephone_number": "772-342-5500"
        },
        {
            "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": "PADILLA FERNANDEZ",
        "first_name": "JUSTIN",
        "middle_name": "ROBERTO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-12-31",
        "last_updated": "2025-12-31",
        "certification_date": "2025-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "FL",
            "license": "RBT-25-497995",
            "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 Dec 31, 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.