Active NPI
Delta Roosevelt
- Behavior Technician
- Oviedo, FL
National Provider Identifier
1750828091
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- Practice address
- 1809 E Broadway St # 122
Oviedo, FL 32765-8597 - Phone
- (407) 359-5693
- Fax
- (407) 792-5693
- NPI assigned
- Jan 25, 2017
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | Primary |
Addresses
Primary practice location
1809 E Broadway St # 122
Oviedo, FL 32765-8597
Mailing address
12112 Goldenstar LN
Clermont, FL 34711-6679
Phone (352) 874-0002
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1485302400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1485302400000",
"number": "1750828091",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12112 GOLDENSTAR LN",
"city": "CLERMONT",
"state": "FL",
"postal_code": "347116679",
"telephone_number": "352-874-0002"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1809 E BROADWAY ST # 122",
"city": "OVIEDO",
"state": "FL",
"postal_code": "327658597",
"telephone_number": "407-359-5693",
"fax_number": "407-792-5693"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROOSEVELT",
"first_name": "DELTA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-01-25",
"last_updated": "2017-01-25",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Oviedo, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.