Rafael Jesse Botta Jr., PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PY7746 Issued in FL

Practice address

9350 Sunset Dr Ste 151
Miami, FL 33173-3286

Phone

(786) 548-1022

NPI assigned

Aug 29, 2008

Last updated

Dec 29, 2023By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Dade Family Counseling Community Mental Health Center, IncGroup PAC ID 0446164982, 12 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Networks

• Freedom Health HMO Network

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

• Dade Family Counseling Community Mental Health Center, Inc

  • Community/Behavioral Health Agency
  • Miami, FL
  • NPI 1427055417
  Medicare reassignment Care Compare group NPD
• Balanced Wellbeing LLC

  • Psychiatry Physician
  • Ocala, FL
  • NPI 1336513639
  Medicare reassignment NPD
• A Different Perspective, LLC

  • Clinical Child & Adolescent Psychologist
  • Pembroke Pines, FL
  • NPI 1801152616
  Authorized official Same address or phone

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

{
    "created_epoch": "1219968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703808000000",
    "number": "1235387440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17900 NW 5TH ST",
            "address_2": "SUITE 201",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330292808",
            "telephone_number": "954-494-6813"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9350 SUNSET DR STE 151",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331733286",
            "telephone_number": "786-548-1022"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "17900 NW 5th St",
            "address_2": "Suite 201",
            "address_purpose": "LOCATION",
            "city": "Pembroke Pines",
            "state": "FL",
            "postal_code": "330292808",
            "country_code": "US",
            "telephone_number": "954-494-6813",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOTTA",
        "first_name": "RAFAEL",
        "middle_name": "JESSE",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-08-29",
        "last_updated": "2023-12-29",
        "certification_date": "2023-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY7746",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sara Marta Botero
• Joseph A Both
• Gerald James Botko, DMD
• Mousa Botros, MD
• Diane Botta, LCSW
• Lilliam Bottaro, LAC
• Avi Botwinick
• Yanet Bou Gomez, ARNP
• Laurice Bou Nemer, M.D.
• Marilyn Marques Bou, SLP

• Clinical Psychologist in Miami, FL
• Providers in Miami, FL by specialty
• Clinical Psychologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.