Individual provider Active NPI

Sofia Baylac Mingo, BCBA, MS

  • Behavior Analyst
  • Miami Beach, FL
National Provider Identifier
1033727094
Registry record updated Dec 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1-24-77432
Practice address
333 W 41St St Ste 414
Miami Beach, FL 33140-3608
Phone
(786) 673-9355
NPI assigned
Jul 16, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X RBT-19-90259
Behavior Analyst 103K00000X 1-24-77432 Primary

Addresses

Primary practice location

333 W 41St St Ste 414
Miami Beach, FL 33140-3608

Mailing address

3624 Tree Ridge LN NE
Palm Bay, FL 32905-4663
Phone (954) 592-3295

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
Credentials
Master of Science

Practice roles

OrganizationSpecialtyStatusNew patients
Pediatric Behavior Therapies, LLC Behavior Analyst Past Accepting new patients
Evolving Minds Together LLC PastSince May 29, 2022 Accepting new patients

Organizations & group practices 2

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": "1594857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733011200000",
    "number": "1033727094",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3624 TREE RIDGE LN NE",
            "city": "PALM BAY",
            "state": "FL",
            "postal_code": "329054663",
            "telephone_number": "954-592-3295"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 W 41ST ST STE 414",
            "city": "MIAMI BEACH",
            "state": "FL",
            "postal_code": "331403608",
            "telephone_number": "786-673-9355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAYLAC MINGO",
        "first_name": "SOFIA",
        "credential": "BCBA, MS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-16",
        "last_updated": "2024-12-01",
        "certification_date": "2024-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": "RBT-19-90259",
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": "1-24-77432",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 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.

Verify at the official NPI Registry.