Leonor Mirtha De Vales

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

Practice address

1285 NW 182ND St
Miami Gardens, FL 33169-4154

Phone

(305) 467-3786

NPI assigned

Nov 21, 2017

Sex

Female

Sole proprietor

No

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

• Leonor Mirtha De Vales Professional name

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Nov 21, 2017.

{
    "created_epoch": "1511222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1511222400000",
    "number": "1194239533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1285 NW 182ND ST",
            "city": "MIAMI GARDENS",
            "state": "FL",
            "postal_code": "331694154",
            "telephone_number": "305-467-3786"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1285 NW 182ND ST",
            "city": "MIAMI GARDENS",
            "state": "FL",
            "postal_code": "331694154",
            "telephone_number": "305-467-3786"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE VALES",
        "first_name": "LEONOR",
        "middle_name": "MIRTHA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-11-21",
        "last_updated": "2017-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "FL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "022013400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LEONOR",
            "last_name": "DE VALES",
            "middle_name": "MIRTHA",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

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• All providers in Miami Gardens, FL
• Behavior Technician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2017; 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.