Individual provider Active NPI

Doris Fonseca

  • Behavior Technician
  • South Miami, FL
National Provider Identifier
1194347294
Registry record updated May 12, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
License
RBT-20-116579 Issued in FL
Practice address
7241 SW 63Rd Ave Ste 101a
South Miami, FL 33143-4838
Phone
(305) 379-8679
Fax
(833) 817-6434
NPI assigned
May 12, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 12, 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 RBT-20-116579 FL Primary

Addresses

Primary practice location

7241 SW 63Rd Ave Ste 101a
South Miami, FL 33143-4838

Mailing address

7241 SW 63Rd Ave Ste 101a
South Miami, FL 33143-4838
Phone (305) 379-8679

Other identifiers 1

IdentifierTypeStateIssuer
RBT-20-116579OtherFLBACB

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-20-116579FLMDBehavior Technician

NPI Registry JSON

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

{
    "created_epoch": "1589241600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589241600000",
    "number": "1194347294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7241 SW 63RD AVE STE 101A",
            "city": "SOUTH MIAMI",
            "state": "FL",
            "postal_code": "331434838",
            "telephone_number": "305-379-8679",
            "fax_number": "833-817-6434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7241 SW 63RD AVE STE 101A",
            "city": "SOUTH MIAMI",
            "state": "FL",
            "postal_code": "331434838",
            "telephone_number": "305-379-8679",
            "fax_number": "833-817-6434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FONSECA",
        "first_name": "DORIS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-05-12",
        "last_updated": "2020-05-12",
        "certification_date": "2020-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "FL",
            "license": "RBT-20-116579",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BACB",
            "identifier": "RBT-20-116579",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in South Miami, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 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.