Individual provider Active NPI

Marbelia Hernandez Gamboa

  • Behavior Analyst
  • Hialeah, FL
National Provider Identifier
1205382348
Registry record updated Sep 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
BCBA-1-21-53375
Practice address
1706 W 66TH PL
Hialeah, FL 33012-6164
Phone
(786) 286-0711
NPI assigned
Aug 29, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X BCBA-1-21-53375 Primary

Addresses

Primary practice location

1706 W 66TH PL
Hialeah, FL 33012-6164

Mailing address

1706 W 66TH PL
Hialeah, FL 33012-6164
Phone (786) 286-0711

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": "1472428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632355200000",
    "number": "1205382348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1706 W 66TH PL",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330126164",
            "telephone_number": "786-286-0711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1706 W 66TH PL",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330126164",
            "telephone_number": "786-286-0711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERNANDEZ GAMBOA",
        "first_name": "MARBELIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-29",
        "last_updated": "2021-09-23",
        "certification_date": "2021-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": "BCBA-1-21-53375",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Sep 23, 2021; 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.