Individual provider Active NPI

Giselle Lopez, OTA

  • Behavior Technician
  • Miramar, FL
National Provider Identifier
1083021646
Registry record updated Sep 8, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
Practice address
12741 SW 17TH CT
Miramar, FL 33027-2500
Phone
(786) 663-0707
Fax
(954) 447-8844
NPI assigned
Jul 16, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 8, 2018

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X RBT-18-63495 FL
Occupational Therapy Assistant 224Z00000X OTA10840 FL
Behavior Technician 106S00000X Primary

Addresses

Primary practice location

12741 SW 17TH CT
Miramar, FL 33027-2500

Mailing address

5611 W 25TH CT Apt 2
Hialeah, FL 33016-4448
Phone (786) 419-9770

Other identifiers 1

IdentifierTypeStateIssuer
RBT-18-63495OtherFLREGISTERED 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
RBT-18-63495FLMDBehavior Technician
OTA10840FLMDOccupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1405468800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536364800000",
    "number": "1083021646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5611 W 25TH CT APT 2",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330164448",
            "telephone_number": "786-419-9770",
            "fax_number": "305-231-9753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12741 SW 17TH CT",
            "city": "MIRAMAR",
            "state": "FL",
            "postal_code": "330272500",
            "telephone_number": "786-663-0707",
            "fax_number": "954-447-8844"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOPEZ",
        "first_name": "GISELLE",
        "credential": "OTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-07-16",
        "last_updated": "2018-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "FL",
            "license": "RBT-18-63495",
            "primary": false
        },
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "FL",
            "license": "OTA10840",
            "primary": false
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGISTERED BEHAVIOR TECHNICIAN",
            "identifier": "RBT-18-63495",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Miramar, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2018; 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.