Active NPI
Kirel Gamboa
- Behavior Technician
- Miami, FL
National Provider Identifier
1215608963
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- Practice address
- 10780 SW 43Rd Ter
Miami, FL 33165-4835 - Phone
- (305) 607-1944
- NPI assigned
- Sep 22, 2021
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | 20-119590 | FL | |
| Behavior Technician | 106S00000X | Primary |
Addresses
Primary practice location
10780 SW 43Rd Ter
Miami, FL 33165-4835
Mailing address
10780 SW 43Rd Ter
Miami, FL 33165-4835
Phone (305) 607-1944
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 857324 | Medicaid | FL |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| SOAP URL | computer | Health Information Exchange (HIE) |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 20-119590 | FL | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1632268800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1681084800000",
"number": "1215608963",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10780 SW 43RD TER",
"city": "MIAMI",
"state": "FL",
"postal_code": "331654835",
"telephone_number": "305-607-1944"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10780 SW 43RD TER",
"city": "MIAMI",
"state": "FL",
"postal_code": "331654835",
"telephone_number": "305-607-1944"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GAMBOA",
"first_name": "KIREL",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-09-22",
"last_updated": "2023-04-10",
"certification_date": "2023-04-10",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "FL",
"license": "20-119590",
"primary": false
},
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "857324",
"state": "FL"
}
],
"endpoints": [
{
"endpointType": "SOAP",
"endpointTypeDescription": "SOAP URL",
"endpoint": "computer",
"affiliation": "N",
"endpointDescription": "secure location",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "computer",
"address_1": "10780 SW 43rd Ter",
"city": "Miami",
"state": "FL",
"country_code": "US",
"postal_code": "331654835",
"country_name": "United States",
"address_type": "DOM"
}
],
"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 Apr 10, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.