Individual provider Active NPI

Shakir Tariq Ibin Naeem

  • Behavior Technician
  • Miami, FL
National Provider Identifier
1285224675
Registry record updated Jan 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
License
BACB616551 Issued in FL
Practice address
10870 SW 113TH PL
Miami, FL 33176-3227
Phone
(305) 846-9346
NPI assigned
Jan 20, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X BACB616551 FL Primary

Addresses

Primary practice location

10870 SW 113TH PL
Miami, FL 33176-3227

Mailing address

9921 SW 162ND St
Miami, FL 33157-3260
Phone (305) 319-0640

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

LicenseStateTypeSpecialty
BACB616551FLMDBehavior Technician

NPI Registry JSON

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

{
    "created_epoch": "1611100800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611100800000",
    "number": "1285224675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9921 SW 162ND ST",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331573260",
            "telephone_number": "305-319-0640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10870 SW 113TH PL",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331763227",
            "telephone_number": "305-846-9346"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IBIN NAEEM",
        "first_name": "SHAKIR",
        "middle_name": "TARIQ",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-01-20",
        "last_updated": "2021-01-20",
        "certification_date": "2021-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "FL",
            "license": "BACB616551",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 20, 2021; 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.