Individual provider Active NPI

Odalys Davila

  • Behavior Technician
  • Miami Springs, FL
National Provider Identifier
1124793955
Registry record updated Aug 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
License
21-151613 Issued in FL
Practice address
511 S Royal Poinciana Blvd Apt 108
Miami Springs, FL 33166-7273
Phone
(786) 307-1677
NPI assigned
Aug 13, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 26, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior TechnicianGroup: 193400000X SINGLE SPECIALTY GROUP 106S00000X 21-151613 FL Primary

Addresses

Primary practice location

511 S Royal Poinciana Blvd Apt 108
Miami Springs, FL 33166-7273

Mailing address

511 S Royal Poinciana Blvd Apt 108
Miami Springs, FL 33166-7273
Phone (786) 307-1677

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
21-151613FLMDBehavior Technician

NPI Registry JSON

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

{
    "created_epoch": "1628812800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629936000000",
    "number": "1124793955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "511 S ROYAL POINCIANA BLVD APT 108",
            "city": "MIAMI SPRINGS",
            "state": "FL",
            "postal_code": "331667273",
            "telephone_number": "786-307-1677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "511 S ROYAL POINCIANA BLVD APT 108",
            "city": "MIAMI SPRINGS",
            "state": "FL",
            "postal_code": "331667273",
            "telephone_number": "786-307-1677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVILA",
        "first_name": "ODALYS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-08-13",
        "last_updated": "2021-08-26",
        "certification_date": "2021-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Behavior Technician",
            "state": "FL",
            "license": "21-151613",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami Springs, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2021; 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.