Individual provider Active NPI

Marvia Elizabeth Dubuc Salerno

  • Behavior Analyst
  • Pembroke Pines, FL
National Provider Identifier
1134718836
Registry record updated Jun 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1-24-71012 Issued in FL
Practice address
17773 SW 2ND St
Pembroke Pines, FL 33029-3924
Phone
(954) 589-2347
NPI assigned
Jan 16, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X
Behavior Technician 106S00000X RBT20132815
Behavior Analyst 103K00000X 1-24-71012 FL Primary

Addresses

Primary practice location

17773 SW 2ND St
Pembroke Pines, FL 33029-3924

Mailing address

17773 SW 2ND St
Pembroke Pines, FL 33029-3924
Phone (954) 589-2347

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": "1610755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718755200000",
    "number": "1134718836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17773 SW 2ND ST",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330293924",
            "telephone_number": "954-589-2347"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17773 SW 2ND ST",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330293924",
            "telephone_number": "954-589-2347"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUBUC SALERNO",
        "first_name": "MARVIA",
        "middle_name": "ELIZABETH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-16",
        "last_updated": "2024-06-19",
        "certification_date": "2024-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": "RBT20132815",
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "FL",
            "license": "1-24-71012",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pembroke Pines, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 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.