Individual provider Active NPI

Deisy Fernandez

  • Behavior Technician
  • Homestead, FL
National Provider Identifier
1013364868
Registry record updated Mar 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
License
15-05702 Issued in FL
Practice address
27700 SW 132ND PL
Homestead, FL 33032-8564
Phone
(305) 910-4490
NPI assigned
May 23, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 26, 2019

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 15-05702 FL Primary

Addresses

Primary practice location

27700 SW 132ND PL
Homestead, FL 33032-8564

Mailing address

27700 SW 132ND PL
Homestead, FL 33032-8564
Phone (305) 910-4490

Other identifiers 1

IdentifierTypeStateIssuer
RBT-15-05702OtherFLREGISTERED BEHAVIOR TECHNICIAN

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
15-05702FLMDBehavior Technician

NPI Registry JSON

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

{
    "created_epoch": "1463961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1553558400000",
    "number": "1013364868",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27700 SW 132ND PL",
            "city": "HOMESTEAD",
            "state": "FL",
            "postal_code": "330328564",
            "telephone_number": "305-910-4490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27700 SW 132ND PL",
            "city": "HOMESTEAD",
            "state": "FL",
            "postal_code": "330328564",
            "telephone_number": "305-910-4490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERNANDEZ",
        "first_name": "DEISY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-05-23",
        "last_updated": "2019-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "FL",
            "license": "15-05702",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGISTERED BEHAVIOR TECHNICIAN",
            "identifier": "RBT-15-05702",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Homestead, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2019; 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.