Brett C Michael

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

1-19-36096 Issued in FL

Practice address

12724 Gran Bay Pkwy W Ste 410
Jacksonville, FL 32258-9486

Phone

(855) 832-6727

NPI assigned

Jun 18, 2019

Last updated

Feb 26, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1560816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614297600000",
    "number": "1760042113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7108 S KANNER HWY",
            "city": "STUART",
            "state": "FL",
            "postal_code": "349977462",
            "telephone_number": "855-832-6727",
            "fax_number": "772-675-9100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12724 GRAN BAY PKWY W STE 410",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322589486",
            "telephone_number": "855-832-6727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MICHAEL",
        "first_name": "BRETT",
        "middle_name": "C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-06-18",
        "last_updated": "2021-02-26",
        "certification_date": "2021-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "FL",
            "license": "1-19-36096",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael E Patch DDS PLLC
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• Michael L Middlebrooks DMD PA
• Michael R. Moore DDS PA (Southpoint Dental Care)
• Michael Stephens Family Practice Inc.
• Briana May Michael
• Cleantha Michael
• Joseph Brian Michael, DMD
• Alexandra Eleanor Michaelis, A.R.N.P.
• Ashley Michaelis, M.S. CCC-SLP

• 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 Feb 26, 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.