Individual provider Active NPI

Iliana D Ravelo Amargos, RBT

  • Behavior Technician
  • Miami, FL
National Provider Identifier
1043784614
Registry record updated Jan 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
License
RBT-18-67138 Issued in FL
Practice address
7040 Coral Way Apt 410
Miami, FL 33155-1682
Phone
(305) 302-8719
NPI assigned
Jan 17, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 17, 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 RBT-18-67138 FL Primary

Addresses

Primary practice location

7040 Coral Way Apt 410
Miami, FL 33155-1682

Mailing address

7040 Coral Way Apt 410
Miami, FL 33155-1682
Phone (305) 302-8719

Other identifiers 1

IdentifierTypeStateIssuer
021585300MedicaidFL

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-18-67138FLMDBehavior Technician

NPI Registry JSON

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

{
    "created_epoch": "1547683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1547683200000",
    "number": "1043784614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7040 CORAL WAY APT 410",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331551682",
            "telephone_number": "305-302-8719"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7040 CORAL WAY APT 410",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331551682",
            "telephone_number": "305-302-8719"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAVELO AMARGOS",
        "first_name": "ILIANA",
        "middle_name": "D",
        "credential": "RBT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-01-17",
        "last_updated": "2019-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "FL",
            "license": "RBT-18-67138",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "021585300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 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.