Juan Carlos Fagundo Perez

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

Practice address

26055 SW 144TH Ave Apt 206
Homestead, FL 33032-5653

Phone

(305) 303-2482

NPI assigned

Oct 23, 2017

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1508716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1508716800000",
    "number": "1255842829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26055 SW 144TH AVE APT 206",
            "city": "HOMESTEAD",
            "state": "FL",
            "postal_code": "330325653",
            "telephone_number": "305-303-2482"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26055 SW 144TH AVE APT 206",
            "city": "HOMESTEAD",
            "state": "FL",
            "postal_code": "330325653",
            "telephone_number": "305-303-2482"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAGUNDO PEREZ",
        "first_name": "JUAN",
        "middle_name": "CARLOS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-10-23",
        "last_updated": "2017-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Behavior Technician",
            "state": "FL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "106S00000X",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Behavior Technician in Homestead, FL
• Providers in Homestead, FL by specialty
• Behavior Technician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2017; 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.