Organization Active NPI

Denali CRT, LLC

  • Behavior Analyst
  • Doral, FL
National Provider Identifier
1326480872
Registry record updated Feb 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
0051701 Issued in FL
Legal business name
DENALI CRT, LLC
Practice address
10200 NW 25TH St Ste 205
Doral, FL 33172-5922
Phone
(305) 602-0268
Fax
(954) 477-7706
NPI assigned
Jul 25, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2025

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

Authorized official

Name
Karina Victoria Gomez
Title
Executive Director
Phone
(305) 602-8074

Specialties & licenses 14

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X MH8888 FL
Behavior AnalystGroup: 193200000X MULTI-SPECIALTY GROUP 103K00000X 0051701 FL Primary
Continuing Education/Staff Development Registered NurseGroup: 193200000X MULTI-SPECIALTY GROUP 163WC1600X
Home Health Registered NurseGroup: 193200000X MULTI-SPECIALTY GROUP 163WH0200X
DriverGroup: 193200000X MULTI-SPECIALTY GROUP 172A00000X
Developmentally Disabled Services Day Training Agency 251C00000X
Nursing Care Agency 251J00000X
Non-emergency Medical Transport (VAN) 343900000X
Home Health AideGroup: 193200000X MULTI-SPECIALTY GROUP 374U00000X
HomemakerGroup: 193200000X MULTI-SPECIALTY GROUP 376J00000X
Nurse's AideGroup: 193200000X MULTI-SPECIALTY GROUP 376K00000X
Respite Care 385H00000X
Child Mental Illness Respite Care 385HR2055X
Child Intellectual and/or Developmental Disabilities Respite Care 385HR2060X

Addresses

Primary practice location

10200 NW 25TH St Ste 205
Doral, FL 33172-5922

Mailing address

10200 NW 25TH St Ste 205
Doral, FL 33172-5922
Phone (305) 602-0268

Other practice location 1

3722 Central Ave Ste 4-5
Fort Myers, FL 33901-8247
Phone (239) 202-0042

Other practice location 2

1860 SW Fountainview Blvd # 1004
Port St Lucie, FL 34986-4535
Phone (772) 877-0341

Other identifiers 2

IdentifierTypeStateIssuer
017511700MedicaidFL
693385896MedicaidFL

National Provider Directory

National Provider Directory

Locations

10200 NW 25th St
Ste 205
Doral, FL 33172
Phone (305) 602-8073

3722 Central Ave
Ste 45
Fort Myers, FL 33901
Phone (239) 202-0042

1860 SW Fountainview Blvd
#1004
Port St Lucie, FL 34986
Phone (772) 877-0341

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1374710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1739836800000",
    "number": "1326480872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10200 NW 25TH ST STE 205",
            "city": "DORAL",
            "state": "FL",
            "postal_code": "331725922",
            "telephone_number": "305-602-0268",
            "fax_number": "954-477-7706"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10200 NW 25TH ST STE 205",
            "city": "DORAL",
            "state": "FL",
            "postal_code": "331725922",
            "telephone_number": "305-602-0268",
            "fax_number": "954-477-7706"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3722 Central Ave Ste 4-5",
            "address_purpose": "LOCATION",
            "city": "Fort Myers",
            "state": "FL",
            "postal_code": "339018247",
            "country_code": "US",
            "telephone_number": "239-202-0042",
            "fax_number": "954-477-7706",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1860 SW Fountainview Blvd # 1004",
            "address_purpose": "LOCATION",
            "city": "Port St Lucie",
            "state": "FL",
            "postal_code": "349864535",
            "country_code": "US",
            "telephone_number": "772-877-0341",
            "fax_number": "772-404-7977",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "DENALI CRT, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-07-25",
        "last_updated": "2025-02-18",
        "certification_date": "2025-02-18",
        "status": "A",
        "authorized_official_last_name": "GOMEZ",
        "authorized_official_first_name": "KARINA",
        "authorized_official_middle_name": "VICTORIA",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "305-602-8074"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH8888",
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Behavior Analyst",
            "state": "FL",
            "license": "0051701",
            "primary": true
        },
        {
            "code": "163WC1600X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse, Continuing Education/Staff Development",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "163WH0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse, Home Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "172A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Driver",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251J00000X",
            "taxonomy_group": "",
            "desc": "Nursing Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "374U00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Home Health Aide",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "376J00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Homemaker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "376K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse's Aide",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "385H00000X",
            "taxonomy_group": "",
            "desc": "Respite Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "385HR2055X",
            "taxonomy_group": "",
            "desc": "Respite Care, Respite Care, Mental Illness, Child",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "385HR2060X",
            "taxonomy_group": "",
            "desc": "Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "017511700",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "693385896",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Doral, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2025; 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.