Individual provider Active NPI

Kevin Olazabal Serrano, RBT 24-336035

  • Behavior Technician
  • Miami, FL
National Provider Identifier
1205676392
Registry record updated May 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
License
24-336035 Issued in FL
Practice address
3701 SW 127TH Ave
Miami, FL 33175-2805
Phone
(786) 255-5008
NPI assigned
May 28, 2024
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 28, 2024

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 24-336035 FL Primary

Addresses

Primary practice location

3701 SW 127TH Ave
Miami, FL 33175-2805

Mailing address

3701 SW 127TH Ave
Miami, FL 33175-2805
Phone (786) 255-5008

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
24-336035FLMDBehavior Technician

NPI Registry JSON

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

{
    "created_epoch": "1716854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716854400000",
    "number": "1205676392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3701 SW 127TH AVE",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331752805",
            "telephone_number": "786-255-5008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3701 SW 127TH AVE",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331752805",
            "telephone_number": "786-255-5008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLAZABAL SERRANO",
        "first_name": "KEVIN",
        "credential": "RBT 24-336035",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-05-28",
        "last_updated": "2024-05-28",
        "certification_date": "2024-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "FL",
            "license": "24-336035",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2024; 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.