Individual provider Active NPI

Andy Medina Rivero

  • Behavior Technician
  • Miami, FL
National Provider Identifier
1114767472
Registry record updated May 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
Practice address
1801 SW 19TH St
Miami, FL 33145-2715
Phone
(786) 354-8790
NPI assigned
May 24, 2024
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 24, 2024

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 Primary

Addresses

Primary practice location

1801 SW 19TH St
Miami, FL 33145-2715

Mailing address

1801 SW 19TH St
Miami, FL 33145-2715
Phone (786) 354-8790

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

NPI Registry JSON

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

{
    "created_epoch": "1716508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716508800000",
    "number": "1114767472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1801 SW 19TH ST",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331452715",
            "telephone_number": "786-354-8790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 SW 19TH ST",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331452715",
            "telephone_number": "786-354-8790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEDINA RIVERO",
        "first_name": "ANDY",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-05-24",
        "last_updated": "2024-05-24",
        "certification_date": "2024-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "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 May 24, 2024; 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.