Individual provider Active NPI

Shavana Rodriguez, BEHAVIOR TECHNICIAN

  • Behavior Technician
  • Cape Coral, FL
National Provider Identifier
1780394841
Registry record updated Nov 30, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
License
RBT-22-245092 Issued in FL
Practice address
3994 Porta Trieste Loop Apt 103
Cape Coral, FL 33909-5478
Phone
(239) 672-6915
NPI assigned
Nov 30, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 30, 2022

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-22-245092 FL Primary

Addresses

Primary practice location

3994 Porta Trieste Loop Apt 103
Cape Coral, FL 33909-5478

Mailing address

3994 Porta Trieste Loop Apt 103
Cape Coral, FL 33909-5478
Phone (239) 672-6915

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-22-245092FLMDBehavior Technician

NPI Registry JSON

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

{
    "created_epoch": "1669766400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669766400000",
    "number": "1780394841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3994 PORTA TRIESTE LOOP APT 103",
            "city": "CAPE CORAL",
            "state": "FL",
            "postal_code": "339095478",
            "telephone_number": "239-672-6915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3994 PORTA TRIESTE LOOP APT 103",
            "city": "CAPE CORAL",
            "state": "FL",
            "postal_code": "339095478",
            "telephone_number": "239-672-6915"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "SHAVANA",
        "credential": "BEHAVIOR TECHNICIAN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-11-30",
        "last_updated": "2022-11-30",
        "certification_date": "2022-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "FL",
            "license": "RBT-22-245092",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cape Coral, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2022; 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.