Individual provider Active NPI

Jessica del Carmen Betancourt Vasallo

  • Behavior Technician
  • Miami, FL
National Provider Identifier
1174345599
Registry record updated Oct 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
Practice address
14631 SW 162ND St
Miami, FL 33177-1776
Phone
(786) 863-8608
NPI assigned
Oct 28, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 28, 2024

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 Primary

Addresses

Primary practice location

14631 SW 162ND St
Miami, FL 33177-1776

Mailing address

14631 SW 162ND St
Miami, FL 33177

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": "1730073600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730073600000",
    "number": "1174345599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14631 SW 162ND ST",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "33177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14631 SW 162ND ST",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331771776",
            "telephone_number": "786-863-8608"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BETANCOURT VASALLO",
        "first_name": "JESSICA DEL CARMEN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-10-28",
        "last_updated": "2024-10-28",
        "certification_date": "2024-10-24",
        "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 28, 2024; 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.