Active NPI
Fiona O'Donovan, M.S., C.C.C. RBT
- Behavior Technician
- Riverview, FL
National Provider Identifier
1821187212
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- Practice address
- 11910 Boyette Rd
Riverview, FL 33569-5601 - Phone
- (813) 350-5005
- NPI assigned
- Oct 12, 2006
- Last updated
- Oct 21, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | SA7792 | FL | |
| Developmental Therapist | 222Q00000X | |||
| Behavior Technician | 106S00000X | Primary |
Addresses
Primary practice location
11910 Boyette Rd
Riverview, FL 33569-5601
Mailing address
11910 Boyette Rd
Riverview, FL 33569-5601
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| S2907 | Other | FL | BC/BS OF FLORIDA # |
| 890302600 | Medicaid | FL | |
| 811980500 | Medicaid | FL |
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SA7792 | FL | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160611200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1571616000000",
"number": "1821187212",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11910 BOYETTE RD",
"city": "RIVERVIEW",
"state": "FL",
"postal_code": "335695601"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11910 BOYETTE RD",
"city": "RIVERVIEW",
"state": "FL",
"postal_code": "335695601",
"telephone_number": "813-350-5005"
}
],
"practiceLocations": [],
"basic": {
"last_name": "O'DONOVAN",
"first_name": "FIONA",
"name_prefix": "Mrs.",
"credential": "M.S., C.C.C. RBT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-12",
"last_updated": "2019-10-21",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "FL",
"license": "SA7792",
"primary": false
},
{
"code": "222Q00000X",
"taxonomy_group": "",
"desc": "Developmental Therapist",
"state": null,
"license": null,
"primary": false
},
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BC/BS OF FLORIDA #",
"identifier": "S2907",
"state": "FL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "890302600",
"state": "FL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "811980500",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Riverview, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.