Tadaichi Milburn

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

License

16-22746 Issued in FL

Practice address

475 S John Rodes Blvd
Melbourne, FL 32904-1093

Phone

(321) 241-1170

Fax

(321) 241-1171

NPI assigned

Sep 6, 2016

Last updated

Jul 21, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• The Sonder Academy

  • Behavior Analyst
  • Melbourne, FL
  • NPI 1023549680
  NPD (past)

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

{
    "created_epoch": "1473120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1043767270",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "475 S JOHN RODES BLVD",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329041093",
            "telephone_number": "321-241-1170",
            "fax_number": "321-241-1170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "475 S JOHN RODES BLVD",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329041093",
            "telephone_number": "321-241-1170",
            "fax_number": "321-241-1171"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1855 W Hibiscus Blvd",
            "address_purpose": "LOCATION",
            "city": "Melbourne",
            "state": "FL",
            "postal_code": "329012622",
            "country_code": "US",
            "telephone_number": "321-345-4232",
            "fax_number": "321-765-6434",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MILBURN",
        "first_name": "TADAICHI",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-09-06",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "FL",
            "license": "16-22746",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "019447600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jennifer Rose Middleton, RRT
• Sarah E Middleton, DPT
• Mackenzi Mies, MT-BC
• Mitchell Francis Miglis, D.C.
• Thomas William Milbourne
• James Timothy Miles, M.D.
• Jason Miles
• Beverly Danielle Milford, FNP-C
• Sarah Millard, APRN
• Elisa Jan Millay, LMHC

• Behavior Technician in Melbourne, FL
• Providers in Melbourne, FL by specialty
• Behavior Technician in Florida

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