Active NPI
Amanda Basulto
- Behavior Technician
- Sweetwater, FL
National Provider Identifier
1144711680
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- Practice address
- 1414 NW 107TH Ave Ste 301
Sweetwater, FL 33172-2742 - Phone
- (786) 537-0500
- NPI assigned
- May 21, 2018
- Last updated
- Mar 8, 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 | NU | Primary |
Addresses
Primary practice location
1414 NW 107TH Ave Ste 301
Sweetwater, FL 33172-2742
Mailing address
7735 NW 48TH St
Doral, FL 33166-5545
Phone (786) 860-5161
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lacosta Therapy, LLC | Behavior Analyst | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1526860800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1615161600000",
"number": "1144711680",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7735 NW 48TH ST",
"city": "DORAL",
"state": "FL",
"postal_code": "331665545",
"telephone_number": "786-860-5161"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1414 NW 107TH AVE STE 301",
"city": "SWEETWATER",
"state": "FL",
"postal_code": "331722742",
"telephone_number": "786-537-0500"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BASULTO",
"first_name": "AMANDA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-05-21",
"last_updated": "2021-03-08",
"certification_date": "2021-03-08",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sweetwater, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 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.