Active NPI
Jennifer Diaz
- Behavior Technician
- Hialeah, FL
National Provider Identifier
1366009573
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- 24586
- Practice address
- 3342 W 90TH Ter
Hialeah, FL 33018-2007 - Phone
- (786) 261-4851
- NPI assigned
- May 22, 2019
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | 24586 | FL | Primary |
Addresses
Primary practice location
3342 W 90TH Ter
Hialeah, FL 33018-2007
Mailing address
3342 W 90TH Ter
Hialeah, FL 33018-2007
Phone (786) 261-4851
Other practice location 1
3342 W 90 Terr
Hialeaf, FL 33018
Phone (786) 261-4851
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
| License | State | Type | Specialty |
|---|---|---|---|
| 24586 | FL | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Vida Healing | Behavior Technician | Past | Accepting new patients |
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": "1558483200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1558483200000",
"number": "1366009573",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3342 W 90TH TER",
"city": "HIALEAH",
"state": "FL",
"postal_code": "330182007",
"telephone_number": "786-261-4851"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3342 W 90TH TER",
"city": "HIALEAH",
"state": "FL",
"postal_code": "330182007",
"telephone_number": "786-261-4851"
}
],
"practiceLocations": [
{
"address_1": "3342 W 90 Terr",
"address_purpose": "LOCATION",
"city": "Hialeaf",
"state": "FL",
"postal_code": "33018",
"country_code": "US",
"telephone_number": "786-261-4851",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "DIAZ",
"first_name": "JENNIFER",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-05-22",
"last_updated": "2019-05-22",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "FL",
"license": "24586",
"primary": true
}
],
"identifiers": [],
"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 May 22, 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.