Active NPI
Laura Fontalvo
- Behavior Technician
- Miami, FL
National Provider Identifier
1174293195
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- Practice address
- 4740 NW 84TH CT Unit 47
Miami, FL 33166-5963 - Phone
- (305) 342-1712
- NPI assigned
- Sep 20, 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 | Primary |
Addresses
Primary practice location
4740 NW 84TH CT Unit 47
Miami, FL 33166-5963
Mailing address
4740 NW 84TH CT Unit 47
Miami, FL 33166-5963
Phone (305) 342-1712
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 109303300 | Medicaid | FL |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | .com |
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": "1632096000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1632096000000",
"number": "1174293195",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4740 NW 84TH CT UNIT 47",
"city": "MIAMI",
"state": "FL",
"postal_code": "331665963",
"telephone_number": "305-342-1712"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4740 NW 84TH CT UNIT 47",
"city": "MIAMI",
"state": "FL",
"postal_code": "331665963",
"telephone_number": "305-342-1712"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FONTALVO",
"first_name": "LAURA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-09-20",
"last_updated": "2021-09-20",
"certification_date": "2021-09-20",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Behavior Technician",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "109303300",
"state": "FL"
}
],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": ".com",
"affiliation": "N",
"address_1": "4740 NW 84th Ct Unit 47",
"city": "Miami",
"state": "FL",
"country_code": "US",
"postal_code": "331665963",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Miami, FL
- Fontainebleau Discount Pharmacy, Inc.
- Fontainebleau Medical Center Corp
- Fontainebleau Medical Supplies Inc
- Fontainebleau Rehabilitation Center Inc.
- Stainely J Fontalvo Mendez
- Nelida Freed Fontana, PHARM D
- Valeria Fontanals, ED.M, SS
- Anait Diaz Fontanella
- Tania Dayane Fontanez-Nieves, M.D.
- Nilsa Fontanez, MSN, CNS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 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.