Active NPI
Tatiana De la Vega
- Behavior Technician
- Homestead, FL
National Provider Identifier
1124699160
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- RBT-21-172525
- Practice address
- 13111 SW 248TH St Apt 305
Homestead, FL 33032-6063 - Phone
- (786) 757-8268
- NPI assigned
- Jul 9, 2021
- 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 | RBT-21-172525 | FL | Primary |
Addresses
Primary practice location
13111 SW 248TH St Apt 305
Homestead, FL 33032-6063
Mailing address
13111 SW 248TH St Apt 305
Homestead, FL 33032-6063
Phone (786) 757-8268
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 111142200 | 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 |
|---|---|---|---|
| RBT-21-172525 | FL | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1625788800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1642550400000",
"number": "1124699160",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13111 SW 248TH ST APT 305",
"city": "HOMESTEAD",
"state": "FL",
"postal_code": "330326063",
"telephone_number": "786-757-8268"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13111 SW 248TH ST APT 305",
"city": "HOMESTEAD",
"state": "FL",
"postal_code": "330326063",
"telephone_number": "786-757-8268"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DE LA VEGA",
"first_name": "TATIANA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-07-09",
"last_updated": "2022-01-19",
"certification_date": "2022-01-19",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "FL",
"license": "RBT-21-172525",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "111142200",
"state": "FL"
}
],
"endpoints": [],
"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 Jan 19, 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.