Maiyen Polo Sosa

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

License

RBT-19-81803 Issued in FL

Practice address

12150 SW 128TH CT Ste 108
Miami, FL 33186-4648

Phone

(786) 732-0607

Fax

(786) 732-0637

NPI assigned

Mar 7, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Masterpiece Behavioral Services, LLC

  • Mental Health Counselor
  • Miami, FL
  • NPI 1083066971
  NPD

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

{
    "created_epoch": "1646611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646611200000",
    "number": "1124775473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13201 SW 200TH TER",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331776150",
            "telephone_number": "305-898-2421"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12150 SW 128TH CT STE 108",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331864648",
            "telephone_number": "786-732-0607",
            "fax_number": "786-732-0637"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLO SOSA",
        "first_name": "MAIYEN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-03-07",
        "last_updated": "2022-03-07",
        "certification_date": "2022-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "FL",
            "license": "RBT-19-81803",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "www.officepuzzle.com",
            "affiliation": "N",
            "address_1": "12150 SW 128th Ct Ste 108",
            "city": "Miami",
            "state": "FL",
            "country_code": "US",
            "postal_code": "331864648",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Lilian Polo Egana
• Judith Cristina Polo Gonzalez I
• Javier Polo Hernandez
• Laura Polo Hernandez
• Lorena Polo Iglesias
• Carmen R Polo Suarez
• Raciel Juan Polo Valdes
• Jose Emilio Polo-Madero, RBT
• Benigno Enrique Polo, MD
• Carlos F Polo

• Behavior Technician in Miami, FL
• Providers in Miami, FL by specialty
• Behavior Technician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 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.