Active NPI
Jennesys Gonzalez
- Behavior Technician
- Kissimmee, FL
National Provider Identifier
1922822162
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- RBT-24-392826
- Practice address
- 102 Park Place Blvd Ste C1
Kissimmee, FL 34741-2358 - Phone
- (407) 385-0728
- NPI assigned
- Nov 14, 2024
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | RBT-24-392826 | FL | Primary |
Addresses
Primary practice location
102 Park Place Blvd Ste C1
Kissimmee, FL 34741-2358
Mailing address
2555 Winners Cir
Kissimmee, FL 34744-3980
Phone (689) 252-4407
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
| License | State | Type | Specialty |
|---|---|---|---|
| RBT-24-392826 | FL | MD | Behavior Technician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| My Ba Therapy Center Inc. | Past | Accepting new patients | |
| My Ba Therapy Center Inc. | Past | Accepting new patients | |
| My Ba Therapy Center Inc. | Past | Accepting new patients |
Organizations & group practices 3
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.
-
- Behavior Analyst
- Kissimmee, FL
- NPI 1326588781
-
- Behavior Analyst
- Kissimmee, FL
- NPI 1952066888
-
- Behavior Analyst
- Kissimmee, FL
- NPI 1962167890
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1731542400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1731542400000",
"number": "1922822162",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2555 WINNERS CIR",
"city": "KISSIMMEE",
"state": "FL",
"postal_code": "347443980",
"telephone_number": "689-252-4407"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "102 PARK PLACE BLVD STE C1",
"city": "KISSIMMEE",
"state": "FL",
"postal_code": "347412358",
"telephone_number": "407-385-0728"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GONZALEZ",
"first_name": "JENNESYS",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-11-14",
"last_updated": "2024-11-14",
"certification_date": "2024-11-13",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "FL",
"license": "RBT-24-392826",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kissimmee, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.