Active NPI
Dylan Fundator
- Behavior Technician
- Miami, FL
National Provider Identifier
1174305908
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- Practice address
- 1301 NE Miami Gardens Dr Apt Ph16W
Ph16W
Miami, FL 33179 - Phone
- (718) 913-4636
- NPI assigned
- Oct 17, 2023
- Sex
- Male
- 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
1301 NE Miami Gardens Dr Apt Ph16W
Ph16W
Miami, FL 33179
Mailing address
1301 NE Miami Gardens Dr Apt Ph16W
Ph16W
Miami, FL 33179
Phone (718) 913-4636
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": "1697500800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1697500800000",
"number": "1174305908",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1301 NE MIAMI GARDENS DR APT PH16W",
"address_2": "PH16W",
"city": "MIAMI",
"state": "FL",
"postal_code": "33179",
"telephone_number": "718-913-4636"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1301 NE MIAMI GARDENS DR APT PH16W",
"address_2": "PH16W",
"city": "MIAMI",
"state": "FL",
"postal_code": "33179",
"telephone_number": "718-913-4636"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FUNDATOR",
"first_name": "DYLAN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2023-10-17",
"last_updated": "2023-10-17",
"certification_date": "2023-10-17",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"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 Oct 17, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.