Individual provider Active NPI

Iuzel Lizamen Miranda, RBT

  • Behavior Technician
  • Lehigh Acres, FL
National Provider Identifier
1972212751
Registry record updated Nov 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
License
RBT-21-154770 Issued in FL
Practice address
2519 39TH St W
Lehigh Acres, FL 33971-6849
Phone
(239) 848-1164
NPI assigned
Nov 21, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 21, 2022

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-21-154770 FL Primary

Addresses

Primary practice location

2519 39TH St W
Lehigh Acres, FL 33971-6849

Mailing address

4106 10TH St W
Lehigh Acres, FL 33971-5006
Phone (239) 848-1164

Other identifiers 1

IdentifierTypeStateIssuer
RBT-21-154770MedicaidFL

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-21-154770FLMDBehavior Technician

Practice roles

OrganizationSpecialtyStatusNew patients
Olokun Home Services Corp CurrentSince Dec 8, 2024 Accepting new patients

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": "1668988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668988800000",
    "number": "1972212751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4106 10TH ST W",
            "city": "LEHIGH ACRES",
            "state": "FL",
            "postal_code": "339715006",
            "telephone_number": "239-848-1164"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2519 39TH ST W",
            "city": "LEHIGH ACRES",
            "state": "FL",
            "postal_code": "339716849",
            "telephone_number": "239-848-1164"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIZAMEN MIRANDA",
        "first_name": "IUZEL",
        "credential": "RBT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-11-21",
        "last_updated": "2022-11-21",
        "certification_date": "2022-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "FL",
            "license": "RBT-21-154770",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "RBT-21-154770",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lehigh Acres, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2022; 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.