Active NPI
Blanca Puentes Gorra
- Behavior Technician
- Miami, FL
National Provider Identifier
1265147391
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- RBT-22-237361
- Practice address
- 3610 SW 112TH Ave Unit 6-2
Miami, FL 33165-3443 - Phone
- (786) 709-1062
- NPI assigned
- Jan 23, 2023
- 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 | RBT-22-237361 | FL | Primary |
Addresses
Primary practice location
3610 SW 112TH Ave Unit 6-2
Miami, FL 33165-3443
Mailing address
3610 SW 112TH Ave Unit 6-2
Miami, FL 33165-3443
Phone (786) 709-1062
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| RBT-22-237361 | Medicaid | FL |
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
| License | State | Type | Specialty |
|---|---|---|---|
| RBT-22-237361 | FL | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1674432000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1674432000000",
"number": "1265147391",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3610 SW 112TH AVE UNIT 6-2",
"city": "MIAMI",
"state": "FL",
"postal_code": "331653443",
"telephone_number": "786-709-1062"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3610 SW 112TH AVE UNIT 6-2",
"city": "MIAMI",
"state": "FL",
"postal_code": "331653443",
"telephone_number": "786-709-1062"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PUENTES GORRA",
"first_name": "BLANCA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-01-23",
"last_updated": "2023-01-23",
"certification_date": "2023-01-23",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "FL",
"license": "RBT-22-237361",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "RBT-22-237361",
"state": "FL"
}
],
"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 Jan 23, 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.