Mariam Itani

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

Practice address

1128 Beville Rd Ste a
Daytona Beach, FL 32114-5769

Phone

(386) 267-3161

Fax

(386) 236-1995

NPI assigned

Mar 13, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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": "1552435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552435200000",
    "number": "1316406002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "175 MIDDLE ST UNIT 1201",
            "city": "LAKE MARY",
            "state": "FL",
            "postal_code": "327463625",
            "telephone_number": "866-610-0580"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1128 BEVILLE RD STE A",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321145769",
            "telephone_number": "386-267-3161",
            "fax_number": "386-236-1995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ITANI",
        "first_name": "MARIAM",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-13",
        "last_updated": "2019-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Behavior Technician in Daytona Beach, FL
• Providers in Daytona Beach, FL by specialty
• Behavior Technician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2019; 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.