Individual provider Active NPI

Miriam Conboy, RBT

  • Behavior Technician
  • Port Orange, FL
National Provider Identifier
1790538882
Registry record updated Jan 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
License
RBT22220207 Issued in FL
Practice address
4647 Clyde Morris Blvd Unit 501
Port Orange, FL 32129-3001
Phone
(386) 767-3752
NPI assigned
Apr 8, 2024
Last updated
Jan 21, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 21, 2026

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 RBT22220207 FL Primary

Addresses

Primary practice location

4647 Clyde Morris Blvd Unit 501
Port Orange, FL 32129-3001

Mailing address

10711 Alden Rd # 3
Jacksonville, FL 32246-9704
Phone (763) 257-6117

Other names 1

  • Miriam Nelson Former name

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
RBT22220207FLMDBehavior Technician

Practice roles

OrganizationSpecialtyStatusNew patients
Ruby Beach Behavioral Pediatrics LLC CurrentSince Apr 14, 2024 Accepting new patients
Strategies, Inc. Behavior Analysis & Therapeutic Services Behavior Technician PastSince Jul 1, 2021 Accepting new patients

Locations

12086 Fort Caroline Rd
Ste 102
Jacksonville, FL 32225
Phone (904) 415-1609

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1712534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768953600000",
    "number": "1790538882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10711 ALDEN RD # 3",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322469704",
            "telephone_number": "763-257-6117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4647 CLYDE MORRIS BLVD UNIT 501",
            "city": "PORT ORANGE",
            "state": "FL",
            "postal_code": "321293001",
            "telephone_number": "386-767-3752"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONBOY",
        "first_name": "MIRIAM",
        "credential": "RBT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-04-08",
        "last_updated": "2026-01-21",
        "certification_date": "2026-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "FL",
            "license": "RBT22220207",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MIRIAM",
            "last_name": "NELSON",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Port Orange, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2026; 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.