Individual provider Active NPI

Awab Abdel-Jalil

  • Behavior Analyst
  • Palm Bay, FL
National Provider Identifier
1245016914
Registry record updated Sep 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Practice address
1320 Culver Dr NE Ste 3
Palm Bay, FL 32907-1104
Phone
(469) 685-5199
NPI assigned
Sep 7, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X Primary

Addresses

Primary practice location

1320 Culver Dr NE Ste 3
Palm Bay, FL 32907-1104

Mailing address

606 Creel St
Melbourne, FL 32935-6584
Phone (469) 685-5199

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

NPI Registry JSON

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

{
    "created_epoch": "1694044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694044800000",
    "number": "1245016914",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "606 CREEL ST",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329356584",
            "telephone_number": "469-685-5199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1320 CULVER DR NE STE 3",
            "city": "PALM BAY",
            "state": "FL",
            "postal_code": "329071104",
            "telephone_number": "469-685-5199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABDEL-JALIL",
        "first_name": "AWAB",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-09-07",
        "last_updated": "2023-09-07",
        "certification_date": "2023-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Bay, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 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.

Verify at the official NPI Registry.