Jennifer De Gennaro Bruzon

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

License

RBT23295597 Issued in FL

Practice address

1801 SE Hillmoor Dr Ste 101
Port St Lucie, FL 34952-7553

Phone

(772) 219-7575

NPI assigned

Sep 11, 2023

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1694390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694390400000",
    "number": "1851178339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2590 SENECA AVE",
            "city": "FORT PIERCE",
            "state": "FL",
            "postal_code": "349466662",
            "telephone_number": "561-508-1825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 SE HILLMOOR DR STE 101",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349527553",
            "telephone_number": "772-219-7575"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE GENNARO BRUZON",
        "first_name": "JENNIFER",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-09-11",
        "last_updated": "2023-09-11",
        "certification_date": "2023-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "FL",
            "license": "RBT23295597",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephen P. Davis, PH.D.
• Patrick Edward Davison, D.O.
• Manjaree Daw, MD
• Jose Ruben Aldo Dawson, NP-C
• Kenyel Day
• Melanie De Guzman, ARNP
• Marielina De la Cruz Garlobo
• Jacqueline Stephanie De la Cruz, MD
• Gina Louise De Loretta, RD (REGISTERED DIETI
• Ingrid J De Mavarez

• Behavior Technician in Port St Lucie, FL
• Providers in Port St Lucie, FL by specialty
• Behavior Technician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2023; 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.