Individual provider Active NPI

Adolfo L Nunez Rodriguez Sr., LMHC, BCBA

  • Behavior Analyst
  • Hialeah, FL
National Provider Identifier
1285961276
Registry record updated Oct 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
BCBA-1-20-41288 Issued in FL
Practice address
2101 W 76TH St
Hialeah, FL 33016
Phone
(786) 773-3393
Fax
(786) 773-3394
NPI assigned
Nov 11, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 28, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X BCBA-1-20-41288 FL Primary
Mental Health Counselor 101YM0800X MH 10015 FL

Addresses

Primary practice location

2101 W 76TH St
Hialeah, FL 33016

Mailing address

5801 E 2ND Ave
Hialeah, FL 33013-1213
Phone (786) 832-0166

Other identifiers 1

IdentifierTypeStateIssuer
017457100MedicaidFL

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
MH 10015FLMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Victory CMH Corp Current Accepting new patients
Clinicas Victoria Inc CurrentSince Jan 19, 2022 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1257897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730073600000",
    "number": "1285961276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5801 E 2ND AVE",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330131213",
            "telephone_number": "786-832-0166",
            "fax_number": "786-773-3394"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2101 W 76TH ST",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "33016",
            "telephone_number": "786-773-3393",
            "fax_number": "786-773-3394"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NUNEZ RODRIGUEZ",
        "first_name": "ADOLFO",
        "middle_name": "L",
        "name_prefix": "Mr.",
        "name_suffix": "Sr.",
        "credential": "LMHC, BCBA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-11-11",
        "last_updated": "2024-10-28",
        "certification_date": "2024-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "FL",
            "license": "BCBA-1-20-41288",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH 10015",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "017457100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hialeah, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2024; 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.