Individual provider Active NPI

Maria Fernanda Martinez Mantilla

  • Behavior Technician
  • Doral, FL
National Provider Identifier
1194241901
Registry record updated May 5, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
Practice address
927 NW 97TH Ave Apt 107
Doral, FL 33172-2380
Phone
(786) 327-9546
NPI assigned
Aug 15, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 5, 2020

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

927 NW 97TH Ave Apt 107
Doral, FL 33172-2380

Mailing address

927 NW 97TH Ave Apt 107
Doral, FL 33172-2380
Phone (786) 327-9546

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

Practice roles

OrganizationSpecialtyStatusNew patients
Heartwell Home Health Care Corp. Past Accepting new patients
Heartwell Home Health Care Corp. Behavior Analyst PastSince Sep 23, 2021 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1502755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588636800000",
    "number": "1194241901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "927 NW 97TH AVE APT 107",
            "city": "DORAL",
            "state": "FL",
            "postal_code": "331722380",
            "telephone_number": "786-327-9546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "927 NW 97TH AVE APT 107",
            "city": "DORAL",
            "state": "FL",
            "postal_code": "331722380",
            "telephone_number": "786-327-9546"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTINEZ MANTILLA",
        "first_name": "MARIA",
        "middle_name": "FERNANDA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-08-15",
        "last_updated": "2020-05-05",
        "certification_date": "2020-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Doral, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2020; 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.