Active NPI
Mia Virtue
- Behavior Technician
- Pembroke Pines, FL
National Provider Identifier
1235861139
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- Practice address
- 18490 Johnson St
Pembroke Pines, FL 33029-3699 - Phone
- (754) 264-8779
- NPI assigned
- Jun 29, 2022
- Last updated
- Jun 29, 2022
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | Primary |
Addresses
Primary practice location
18490 Johnson St
Pembroke Pines, FL 33029-3699
Mailing address
1551 NW 125TH Ave Apt 9304
Sunrise, FL 33323-5248
Phone (786) 724-5172
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Behavioral Initiatives, LLC | Behavior Technician | Past | Accepting new patients |
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1656460800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1656460800000",
"number": "1235861139",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1551 NW 125TH AVE APT 9304",
"city": "SUNRISE",
"state": "FL",
"postal_code": "333235248",
"telephone_number": "786-724-5172"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "18490 JOHNSON ST",
"city": "PEMBROKE PINES",
"state": "FL",
"postal_code": "330293699",
"telephone_number": "754-264-8779"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VIRTUE",
"first_name": "MIA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-06-29",
"last_updated": "2022-06-29",
"certification_date": "2022-06-29",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"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 Jun 29, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.