Individual provider Active NPI

Miguel A Chang

  • Behavior Technician
  • Greenacres, FL
National Provider Identifier
1174170666
Registry record updated Mar 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
License
RBT-19-89755 Issued in FL
Practice address
6801 Lake Worth Rd Ste 322
Greenacres, FL 33467-2966
Phone
(561) 771-9561
Fax
(800) 766-3139
NPI assigned
Aug 20, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 1, 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-19-89755 FL Primary

Addresses

Primary practice location

6801 Lake Worth Rd Ste 322
Greenacres, FL 33467-2966

Mailing address

2802 Oklahoma St
West Palm Beach, FL 33406-4214
Phone (561) 201-8731

Other identifiers 1

IdentifierTypeStateIssuer
103954000MedicaidFL

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-19-89755FLMDBehavior Technician

NPI Registry JSON

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

{
    "created_epoch": "1566259200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646092800000",
    "number": "1174170666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2802 OKLAHOMA ST",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334064214",
            "telephone_number": "561-201-8731"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6801 LAKE WORTH RD STE 322",
            "city": "GREENACRES",
            "state": "FL",
            "postal_code": "334672966",
            "telephone_number": "561-771-9561",
            "fax_number": "800-766-3139"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHANG",
        "first_name": "MIGUEL",
        "middle_name": "A",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-08-20",
        "last_updated": "2022-03-01",
        "certification_date": "2022-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "FL",
            "license": "RBT-19-89755",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "103954000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenacres, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 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.