Active NPI
Lisandra Comas Roldan
- Behavior Analyst
- Miami, FL
National Provider Identifier
1114697323
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 12156730
- Practice address
- 1060 NW 123Rd CT Unit 801
Miami, FL 33182-2431 - Phone
- (786) 398-2565
- NPI assigned
- Sep 18, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | |||
| Assistant Behavior Analyst | 106E00000X | 02112691 | ||
| Behavior Technician | 106S00000X | 20112993 | FL | |
| Behavior Analyst | 103K00000X | 12156730 | FL | Primary |
Addresses
Primary practice location
1060 NW 123Rd CT Unit 801
Miami, FL 33182-2431
Mailing address
1060 NW 123Rd CT Unit 801
Miami, FL 33182-2431
Phone (786) 398-2565
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 109481900 | Medicaid | FL |
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 |
|---|---|---|---|
| 12156730 | FL | MD | Behavioral Analyst |
| 20112993 | FL | MD | Behavior Technician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Blue Giraffe Health Services, Inc | Behavior Analyst | Past | 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.
-
- Behavior Analyst
- Miami, FL
- NPI 1386001360
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1631923200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1641168000000",
"number": "1114697323",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1060 NW 123RD CT UNIT 801",
"city": "MIAMI",
"state": "FL",
"postal_code": "331822431",
"telephone_number": "786-398-2565"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1060 NW 123RD CT UNIT 801",
"city": "MIAMI",
"state": "FL",
"postal_code": "331822431",
"telephone_number": "786-398-2565"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COMAS ROLDAN",
"first_name": "LISANDRA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-09-18",
"last_updated": "2022-01-03",
"certification_date": "2022-01-03",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": null,
"license": null,
"primary": false
},
{
"code": "106E00000X",
"taxonomy_group": "",
"desc": "Assistant Behavior Analyst",
"state": null,
"license": "02112691",
"primary": false
},
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "FL",
"license": "20112993",
"primary": false
},
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "FL",
"license": "12156730",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "109481900",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Miami, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 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.