Individual provider Active NPI

Herly Hernandez Santana, RBT

  • Behavior Technician
  • Pembroke Pines, FL
National Provider Identifier
1205433604
Registry record updated Oct 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
License
RBT-20-119416 Issued in FL
Practice address
3 SW 129TH Ave Ste 203
Pembroke Pines, FL 33027-1779
Phone
(954) 589-2539
NPI assigned
Oct 8, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 8, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior TechnicianGroup: 193400000X SINGLE SPECIALTY GROUP 106S00000X RBT-20-119416 FL Primary

Addresses

Primary practice location

3 SW 129TH Ave Ste 203
Pembroke Pines, FL 33027-1779

Mailing address

2030 NW 29TH St
Miami, FL 33142-5994
Phone (786) 812-6153

Other practice location 1

4830 NW 167th St
Miami Lakes, FL 33014-6426
Phone (786) 812-6153

Other identifiers 1

IdentifierTypeStateIssuer
106614000MedicaidFL

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-20-119416FLMDBehavior Technician

NPI Registry JSON

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

{
    "created_epoch": "1602115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602115200000",
    "number": "1205433604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2030 NW 29TH ST",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331425994",
            "telephone_number": "786-812-6153"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 SW 129TH AVE STE 203",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330271779",
            "telephone_number": "954-589-2539"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4830 NW 167th St",
            "address_purpose": "LOCATION",
            "city": "Miami Lakes",
            "state": "FL",
            "postal_code": "330146426",
            "country_code": "US",
            "telephone_number": "786-812-6153",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HERNANDEZ SANTANA",
        "first_name": "HERLY",
        "credential": "RBT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-10-08",
        "last_updated": "2020-10-08",
        "certification_date": "2020-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Behavior Technician",
            "state": "FL",
            "license": "RBT-20-119416",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "106614000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pembroke Pines, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 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.