Individual provider Active NPI

Marlen Gamez Diaz

  • Assistant Behavior Analyst
  • Tampa, FL
National Provider Identifier
1831609445
Registry record updated Nov 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assistant Behavior AnalystTaxonomy code 106E00000X
License
02113074 Issued in CO
Practice address
8608 Huron CT Unit 60
Tampa, FL 33614-2059
Phone
(786) 557-2858
NPI assigned
Oct 9, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 8, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X FL
Assistant Behavior Analyst 106E00000X 02113074 CO Primary

Addresses

Primary practice location

8608 Huron CT Unit 60
Tampa, FL 33614-2059

Mailing address

8608 Huron CT Unit 60
Tampa, FL 33614-2059
Phone (786) 557-2858

Other names 1

  • Marlen Gamez Diaz 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
02113074COMDAssistant Behavior Analyst

NPI Registry JSON

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

{
    "created_epoch": "1507507200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636329600000",
    "number": "1831609445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8608 HURON CT UNIT 60",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336142059",
            "telephone_number": "786-557-2858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8608 HURON CT UNIT 60",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336142059",
            "telephone_number": "786-557-2858"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAMEZ DIAZ",
        "first_name": "MARLEN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-10-09",
        "last_updated": "2021-11-08",
        "certification_date": "2021-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "FL",
            "license": null,
            "primary": false
        },
        {
            "code": "106E00000X",
            "taxonomy_group": "",
            "desc": "Assistant Behavior Analyst",
            "state": "CO",
            "license": "02113074",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARLEN",
            "last_name": "GAMEZ DIAZ",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Tampa, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 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.