Individual provider Active NPI

Christian Ruby Carbonell, BCBA

  • Behavior Analyst
  • Miramar, FL
National Provider Identifier
1093961740
Registry record updated Apr 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1-09-6542 Issued in FL
Practice address
12801 SW 30TH St
Miramar, FL 33027-5300
Phone
(305) 469-3603
NPI assigned
Aug 13, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 5, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Developmental Therapist 222Q00000X
Early Intervention Provider Agency 252Y00000X 0-02-0435 CERTIFICAT FL
Behavior Analyst 103K00000X 1-09-6542 FL Primary

Addresses

Primary practice location

12801 SW 30TH St
Miramar, FL 33027-5300

Mailing address

12801 SW 30TH St
Miramar, FL 33027-5300
Phone (305) 469-3603

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

Practice roles

OrganizationSpecialtyStatusNew patients
Bri-ABA Services, LLC CurrentSince Apr 10, 2022 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1218585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649116800000",
    "number": "1093961740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12801 SW 30TH ST",
            "city": "MIRAMAR",
            "state": "FL",
            "postal_code": "330275300",
            "telephone_number": "305-469-3603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12801 SW 30TH ST",
            "city": "MIRAMAR",
            "state": "FL",
            "postal_code": "330275300",
            "telephone_number": "305-469-3603"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARBONELL",
        "first_name": "CHRISTIAN",
        "middle_name": "RUBY",
        "name_prefix": "Mrs.",
        "credential": "BCBA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-08-13",
        "last_updated": "2022-04-05",
        "certification_date": "2022-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "222Q00000X",
            "taxonomy_group": "",
            "desc": "Developmental Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": "FL",
            "license": "0-02-0435 CERTIFICAT",
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "FL",
            "license": "1-09-6542",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Apr 5, 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.