Active NPI
Giselle Lopez, OTA
- Behavior Technician
- Miramar, FL
National Provider Identifier
1083021646
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| RBT-18-63495 | Other | FL | REGISTERED 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
| License | State | Type | Specialty |
|---|---|---|---|
| RBT-18-63495 | FL | MD | Behavior Technician |
| OTA10840 | FL | MD | Occupational 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.