Individual provider Active NPI

Keilyn De la Caridad Martinez

  • Behavior Analyst
  • Hialeah, FL
National Provider Identifier
1184372476
Registry record updated Aug 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1-24-75102 Issued in FL
Practice address
7396 W 18TH Ave
Hialeah, FL 33014-3711
Phone
(786) 394-3752
NPI assigned
Mar 15, 2022
Last updated
Aug 27, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X 1-24-75102 FL Primary
Behavior Technician 106S00000X RBT-20-119318 FL

Addresses

Primary practice location

7396 W 18TH Ave
Hialeah, FL 33014-3711

Mailing address

7396 W 18TH Ave
Hialeah, FL 33014-3711
Phone (786) 394-3752

Other identifiers 1

IdentifierTypeStateIssuer
107251600MedicaidFL

Other names 1

  • Keilyn De la Caridad Martinez Other name

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-20-119318FLMDBehavior Technician

NPI Registry JSON

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

{
    "created_epoch": "1647302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724716800000",
    "number": "1184372476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7396 W 18TH AVE",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330143711",
            "telephone_number": "786-394-3752"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7396 W 18TH AVE",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330143711",
            "telephone_number": "786-394-3752"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTINEZ",
        "first_name": "KEILYN",
        "middle_name": "DE LA CARIDAD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-15",
        "last_updated": "2024-08-27",
        "certification_date": "2024-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "FL",
            "license": "1-24-75102",
            "primary": true
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "FL",
            "license": "RBT-20-119318",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "107251600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KEILYN",
            "last_name": "MARTINEZ",
            "middle_name": "DE LA CARIDAD",
            "credential": "KEILYN MARTINEZ",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Hialeah, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 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.