Individual provider Active NPI

Raquel Dominguez

  • Assistant Behavior Analyst
  • Miami, FL
National Provider Identifier
1225654007
Registry record updated Jun 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assistant Behavior AnalystTaxonomy code 106E00000X
License
RBT-20-122266 Issued in FL
Practice address
14425 Country Walk Dr
Miami, FL 33186-8103
Phone
(786) 349-4700
Fax
(786) 701-2635
NPI assigned
Jun 17, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assistant Behavior Analyst 106E00000X RBT-20-122266 FL Primary

Addresses

Primary practice location

14425 Country Walk Dr
Miami, FL 33186-8103

Mailing address

13756 SW 149TH Circle LN Apt 4
Miami, FL 33186-5789
Phone (305) 742-7911

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-20-122266FLMDAssistant Behavior Analyst

Practice roles

OrganizationSpecialtyStatusNew patients
My Kid Therapy Center PastSince Jun 21, 2020 Accepting new patients
My Kid Speech and Occupational Corp PastSince Jun 21, 2020 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1592352000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592352000000",
    "number": "1225654007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13756 SW 149TH CIRCLE LN APT 4",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331865789",
            "telephone_number": "305-742-7911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14425 COUNTRY WALK DR",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331868103",
            "telephone_number": "786-349-4700",
            "fax_number": "786-701-2635"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOMINGUEZ",
        "first_name": "RAQUEL",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-17",
        "last_updated": "2020-06-17",
        "certification_date": "2020-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106E00000X",
            "taxonomy_group": "",
            "desc": "Assistant Behavior Analyst",
            "state": "FL",
            "license": "RBT-20-122266",
            "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 Jun 17, 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.