Active NPI
Roneldo Jefferson Jean Jacques
- Behavior Technician
- Fort Myers, FL
National Provider Identifier
1952017675
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- Practice address
- 12493 Brantley Commons CT
Fort Myers, FL 33907-5693 - Phone
- (239) 268-8707
- NPI assigned
- Jan 26, 2023
- Sex
- Male
- Sole proprietor
- No
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 | FL | Primary |
Addresses
Primary practice location
12493 Brantley Commons CT
Fort Myers, FL 33907-5693
Mailing address
3501 20TH St SW
Lehigh Acres, FL 33976-3405
Phone (239) 645-8426
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
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Smart Endeavors Therapy Services, LLC. | Current | Accepting new patients |
Locations
12493 Brantley Commons Ct
Fort Myers, FL 33907
Phone (239) 268-8707
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.
-
- Speech-Language Pathologist
- Fort Myers, FL
- NPI 1356093777
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1674691200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1674691200000",
"number": "1952017675",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3501 20TH ST SW",
"city": "LEHIGH ACRES",
"state": "FL",
"postal_code": "339763405",
"telephone_number": "239-645-8426"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12493 BRANTLEY COMMONS CT",
"city": "FORT MYERS",
"state": "FL",
"postal_code": "339075693",
"telephone_number": "239-268-8707"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JEAN JACQUES",
"first_name": "RONELDO",
"middle_name": "JEFFERSON",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-01-26",
"last_updated": "2023-01-26",
"certification_date": "2023-01-26",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "FL",
"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 Jan 26, 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.