Individual provider Active NPI

Madelvis Martinez Quiroga

  • Behavior Technician
  • Miami, FL
National Provider Identifier
1164176715
Registry record updated Feb 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
License
RBT-20-122191 Issued in FL
Practice address
14230 Graves Dr
Miami, FL 33176-6432
Phone
(786) 376-7108
NPI assigned
Feb 11, 2022
Last updated
Feb 11, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 11, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X RBT-20-122191 FL Primary

Addresses

Primary practice location

14230 Graves Dr
Miami, FL 33176-6432

Mailing address

14230 Graves Dr
Miami, FL 33176-6432
Phone (786) 376-7108

Other identifiers 1

IdentifierTypeStateIssuer
1MedicaidFL

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
RBT-20-122191FLMDBehavior Technician

NPI Registry JSON

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

{
    "created_epoch": "1644537600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644537600000",
    "number": "1164176715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14230 GRAVES DR",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331766432",
            "telephone_number": "786-376-7108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14230 GRAVES DR",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331766432",
            "telephone_number": "786-376-7108"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTINEZ QUIROGA",
        "first_name": "MADELVIS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-02-11",
        "last_updated": "2022-02-11",
        "certification_date": "2022-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "FL",
            "license": "RBT-20-122191",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 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.