Active NPI
Ivis Lazara Fuentes Diaz
- Behavior Analyst
- Miami, FL
National Provider Identifier
1184315236
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- BCBA-1-25-86289
- Practice address
- 11625 SW 168TH Ter
Miami, FL 33157-3955 - Phone
- (786) 771-1206
- NPI assigned
- May 18, 2023
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | F532-412-91-847-0 | FL | |
| Behavior Analyst | 103K00000X | BCBA-1-25-86289 | FL | Primary |
Addresses
Primary practice location
11625 SW 168TH Ter
Miami, FL 33157-3955
Mailing address
11625 SW 168TH Ter
Miami, FL 33157-3955
Phone (786) 771-1206
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": "1684368000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1765756800000",
"number": "1184315236",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11625 SW 168TH TER",
"city": "MIAMI",
"state": "FL",
"postal_code": "331573955",
"telephone_number": "786-771-1206"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11625 SW 168TH TER",
"city": "MIAMI",
"state": "FL",
"postal_code": "331573955",
"telephone_number": "786-771-1206"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FUENTES DIAZ",
"first_name": "IVIS",
"middle_name": "LAZARA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-05-18",
"last_updated": "2025-12-15",
"certification_date": "2025-12-15",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "FL",
"license": "F532-412-91-847-0",
"primary": false
},
{
"code": "103K00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Behavior Analyst",
"state": "FL",
"license": "BCBA-1-25-86289",
"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 Dec 15, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.