Individual provider Active NPI

Serina Wirth

  • Behavior Technician
  • Fort Myers, FL
National Provider Identifier
1902583420
Registry record updated Sep 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
Practice address
12501 World Plaza LN BLDG 51
Fort Myers, FL 33907-3991
Phone
(239) 349-3139
NPI assigned
Jun 28, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2023

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 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

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

Practice roles

OrganizationSpecialtyStatusNew patients
Autism Services of FL CurrentSince Jul 1, 2023 Accepting new patients

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

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1687910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694476800000",
    "number": "1902583420",
    "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"
        },
        {
            "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"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIRTH",
        "first_name": "SERINA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-28",
        "last_updated": "2023-09-12",
        "certification_date": "2023-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "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 Sep 12, 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.