Individual provider Active NPI

Leslie Ann Todisco, RBT

  • Behavior Technician
  • Melbourne, FL
National Provider Identifier
1881367613
Registry record updated Jul 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
License
RBT-21-177231 Issued in FL
Practice address
4329 Wellington Rd
Melbourne, FL 32935-2454
Phone
(321) 914-8465
Fax
(407) 960-3009
NPI assigned
Jul 28, 2021
Last updated
Jul 28, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 28, 2021

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 RBT-21-177231 FL Primary

Addresses

Primary practice location

4329 Wellington Rd
Melbourne, FL 32935-2454

Mailing address

4329 Wellington Rd
Melbourne, FL 32935-2454
Phone (321) 914-8465

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
RBT-21-177231FLMDBehavior Technician

NPI Registry JSON

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

{
    "created_epoch": "1627430400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627430400000",
    "number": "1881367613",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4329 WELLINGTON RD",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329352454",
            "telephone_number": "321-914-8465",
            "fax_number": "407-960-3009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4329 WELLINGTON RD",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329352454",
            "telephone_number": "321-914-8465",
            "fax_number": "407-960-3009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TODISCO",
        "first_name": "LESLIE",
        "middle_name": "ANN",
        "credential": "RBT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-07-28",
        "last_updated": "2021-07-28",
        "certification_date": "2021-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "FL",
            "license": "RBT-21-177231",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Melbourne, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 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.