Active NPI
Agilda Gomez
- Behavior Technician
- Hialeah, FL
National Provider Identifier
1114525409
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- 20-131868
- Practice address
- 7250 NW 177TH St Apt 206
Hialeah, FL 33015-6238 - Phone
- (786) 343-3012
- NPI assigned
- Oct 9, 2020
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | 20-131868 | FL | Primary |
Addresses
Primary practice location
7250 NW 177TH St Apt 206
Hialeah, FL 33015-6238
Mailing address
7250 NW 177TH St Apt 206
Hialeah, FL 33015-6238
Phone (786) 343-3012
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 |
|---|---|---|---|
| 20-131868 | FL | MD | Behavior Technician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Inkredible Minds LLC | Current | 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.
-
- Community/Behavioral Health Agency
- Hialeah, FL
- NPI 1265203848
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1602201600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1602201600000",
"number": "1114525409",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7250 NW 177TH ST APT 206",
"city": "HIALEAH",
"state": "FL",
"postal_code": "330156238",
"telephone_number": "786-343-3012"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7250 NW 177TH ST APT 206",
"city": "HIALEAH",
"state": "FL",
"postal_code": "330156238",
"telephone_number": "786-343-3012"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOMEZ",
"first_name": "AGILDA",
"name_prefix": "Ms.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-10-09",
"last_updated": "2020-10-09",
"certification_date": "2020-10-09",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "FL",
"license": "20-131868",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hialeah, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.