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1376343939 NPI number — ANIS LAURA PERALTA RBT

NPI Number: 1376343939
Health Care Provider/Practitioner: ANIS LAURA PERALTA RBT

Information about “1376343939” NPI (ANIS LAURA PERALTA RBT) exists in 1376343939 in HTML format HTML  |  1376343939 in plain Text format TXT  |  1376343939 in PDF (Portable Document Format) PDF  |  1376343939 in an XML format XML  formats.

NPI Number : 1376343939 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1376343939",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "PERALTA",
    "FirstName": "ANIS",
    "MiddleName": "LAURA",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "RBT",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "4129 TARGEE AVE",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "NORTH PORT",
    "MailingAddressStateName": "FL",
    "MailingAddressPostalCode": "34287-4222",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": null,
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "18245 PAULSON DR # 104",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "PORT CHARLOTTE",
    "PracticeLocationAddressStateName": "FL",
    "PracticeLocationAddressPostalCode": "33954-1019",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "504-338-4316",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "03/13/2025",
    "LastUpdateDate": "04/08/2025",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "106S00000X",
        "TaxonomyName": "Behavior Technician",
        "LicenseNumber": "BACB1281623",
        "LicenseNumberStateCode": "FL",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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