Individual provider Active NPI

Ysacris Fernandez

  • Behavior Technician
  • Homestead, FL
National Provider Identifier
1114674173
Registry record updated Mar 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
License
RBT-20-125760 Issued in FL
Practice address
25801 S Dixie Hwy Apt 1024
Homestead, FL 33032-5525
Phone
(305) 834-6044
NPI assigned
Mar 9, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 9, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X RBT-20-125760 FL Primary

Addresses

Primary practice location

25801 S Dixie Hwy Apt 1024
Homestead, FL 33032-5525

Mailing address

25801 S Dixie Hwy Apt 1024
Homestead, FL 33032-5525
Phone (305) 834-6044

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address yfernandez_klc@outlook.com

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-20-125760FLMDBehavior Technician

NPI Registry JSON

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

{
    "created_epoch": "1646784000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646784000000",
    "number": "1114674173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25801 S DIXIE HWY APT 1024",
            "city": "HOMESTEAD",
            "state": "FL",
            "postal_code": "330325525",
            "telephone_number": "305-834-6044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25801 S DIXIE HWY APT 1024",
            "city": "HOMESTEAD",
            "state": "FL",
            "postal_code": "330325525",
            "telephone_number": "305-834-6044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERNANDEZ",
        "first_name": "YSACRIS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-03-09",
        "last_updated": "2022-03-09",
        "certification_date": "2022-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "FL",
            "license": "RBT-20-125760",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "yfernandez_klc@outlook.com",
            "affiliation": "N",
            "address_1": "25801 S Dixie Hwy Apt 1024",
            "city": "Homestead",
            "state": "FL",
            "country_code": "US",
            "postal_code": "330325525",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Homestead, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 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.