Jorge Luis Coello, RBT

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

License

22-218526 Issued in FL

Practice address

7875 NW 12TH St Ste 109
Doral, FL 33126-1815

Phone

(786) 269-3502

Fax

(305) 468-6154

NPI assigned

Jul 16, 2022

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Crystal Minds Psychological Services

  • Psychologist
  • Doral, FL
  • NPI 1316408180
  NPD

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

{
    "created_epoch": "1657929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657929600000",
    "number": "1053045872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24544 SW 115TH CT",
            "city": "HOMESTEAD",
            "state": "FL",
            "postal_code": "330324711",
            "telephone_number": "786-631-6104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7875 NW 12TH ST STE 109",
            "city": "DORAL",
            "state": "FL",
            "postal_code": "331261815",
            "telephone_number": "786-269-3502",
            "fax_number": "305-468-6154"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COELLO",
        "first_name": "JORGE",
        "middle_name": "LUIS",
        "name_prefix": "Mr.",
        "credential": "RBT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-07-16",
        "last_updated": "2022-07-16",
        "certification_date": "2022-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "FL",
            "license": "22-218526",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carlos Sebastian Coba San Lucas
• Yalena Cobos Ramentol
• Coco Services & Solutions Inc
• Code of Conduct
• Mikael Alexander Codinach
• Lidia Coello
• Onelkys Cofino Carballo
• Harris Cohen
• Joy Cohen, CRNA
• Michelle Cole

• Behavior Technician in Doral, FL
• Providers in Doral, 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 16, 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.