Individual provider Active NPI

Ketzylie M Santiago Rivera

  • Behavior Technician
  • Doral, FL
National Provider Identifier
1336935683
Registry record updated Apr 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
Practice address
7875 NW 12TH St Ste 118
Doral, FL 33126-1815
Phone
(786) 505-4449
Fax
(786) 667-3733
NPI assigned
Apr 15, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 15, 2025

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 Primary

Addresses

Primary practice location

7875 NW 12TH St Ste 118
Doral, FL 33126-1815

Mailing address

8260 SW 210TH St Apt 215
Cutler Bay, FL 33189-3476
Phone (701) 391-4009

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

Practice roles

OrganizationSpecialtyStatusNew patients
Peace of Mind Jax CurrentSince Apr 20, 2025 Accepting new patients

Locations

7875 NW 12th St
Ste 118
Doral, FL 33126
Phone (786) 505-4449

Organizations & group practices 1

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": "1744675200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744675200000",
    "number": "1336935683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8260 SW 210TH ST APT 215",
            "city": "CUTLER BAY",
            "state": "FL",
            "postal_code": "331893476",
            "telephone_number": "701-391-4009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7875 NW 12TH ST STE 118",
            "city": "DORAL",
            "state": "FL",
            "postal_code": "331261815",
            "telephone_number": "786-505-4449",
            "fax_number": "786-667-3733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANTIAGO RIVERA",
        "first_name": "KETZYLIE",
        "middle_name": "M",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-04-15",
        "last_updated": "2025-04-15",
        "certification_date": "2025-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Apr 15, 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.