NPIMap

Organization Active NPI

Autism Services of FL

  • Behavior Analyst
  • Fort Myers, FL
National Provider Identifier
1801471081
Registry record updated Apr 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Legal business name
AUTISM SERVICES OF FL
Practice address
12501 World Plaza LN BLDG 51
Fort Myers, FL 33907-3991
Phone
(239) 349-3139
Fax
(239) 984-4372
NPI assigned
Mar 10, 2021
Last updated
Apr 17, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2024

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

Authorized official

Name
Mrs. Nicole Pamela Edge, MS, BCBANPI 1740680487
Title
Owner
Phone
(239) 707-3383

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X NU Primary

Addresses

Primary practice location

12501 World Plaza LN BLDG 51
Fort Myers, FL 33907-3991

Mailing address

12501 World Plaza LN BLDG 51
Fort Myers, FL 33907-3991
Phone (239) 349-3139

National Provider Directory

National Provider Directory

Locations

12438 Brantley Commons Ct
Fort Myers, FL 33907
Phone (239) 270-5921

12501 World Plaza Ln
Bldg 51
Fort Myers, FL 33907
Phone (239) 349-3139

Practitioners & affiliated clinicians

Practitioners 77

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 77

NPI Registry JSON

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

{
    "created_epoch": "1615334400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1713312000000",
    "number": "1801471081",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12501 WORLD PLAZA LN BLDG 51",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339073991",
            "telephone_number": "239-349-3139",
            "fax_number": "239-984-4372"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12501 WORLD PLAZA LN BLDG 51",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339073991",
            "telephone_number": "239-349-3139",
            "fax_number": "239-984-4372"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AUTISM SERVICES OF FL",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-10",
        "last_updated": "2024-04-17",
        "certification_date": "2024-04-17",
        "status": "A",
        "authorized_official_last_name": "EDGE",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_middle_name": "PAMELA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "239-707-3383",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MS, BCBA"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Myers, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2024; 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.