Individual provider Active NPI

Marcia Raimundo

  • Behavior Analyst
  • Miami, FL
National Provider Identifier
1366857179
Registry record updated Aug 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1-21-50160 Issued in FL
Practice address
20721 SW 116TH Rd
Miami, FL 33189
Phone
(786) 307-5089
NPI assigned
Jul 1, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 22, 2023

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X 6071 TX
Behavior Technician 106S00000X RBT-18-56688 FL
Case Manager/Care Coordinator 171M00000X
Behavior Analyst 103K00000X 1-21-50160 FL Primary

Addresses

Primary practice location

20721 SW 116TH Rd
Miami, FL 33189

Mailing address

20721 SW 116TH Rd
Miami, FL 33189-1039
Phone (786) 307-5089

Other practice location 1

830 Wildgrove Dr
Garland, TX 75041-4433
Phone (786) 307-5089

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

LicenseStateTypeSpecialty
6071TXMDBehavioral Analyst
RBT-18-56688FLMDBehavior Technician

Practice roles

OrganizationSpecialtyStatusNew patients
Bright Therapy Solution Inc Behavior Analyst Current Accepting new patients
Bright Therapy Services Behavior Analyst CurrentSince Jul 1, 2023 Accepting new patients
Sunny Behavior LLC Behavior Analyst Past Accepting new patients

Locations

5180 Western Center Blvd
Haltom City, TX 76137
Phone (682) 888-5983

Organizations & group practices 3

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": "1404172800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692662400000",
    "number": "1366857179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20721 SW 116TH RD",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331891039",
            "telephone_number": "786-307-5089"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20721 SW 116TH RD",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "33189",
            "telephone_number": "786-307-5089"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "830 Wildgrove Dr",
            "address_purpose": "LOCATION",
            "city": "Garland",
            "state": "TX",
            "postal_code": "750414433",
            "country_code": "US",
            "telephone_number": "786-307-5089",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RAIMUNDO",
        "first_name": "MARCIA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-07-01",
        "last_updated": "2023-08-22",
        "certification_date": "2023-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "TX",
            "license": "6071",
            "primary": false
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "FL",
            "license": "RBT-18-56688",
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "FL",
            "license": "1-21-50160",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2023; 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.