Individual provider Active NPI

Elvis Moreno Acanda

  • Behavior Technician
  • Pembroke Pines, FL
National Provider Identifier
1407573264
Registry record updated Oct 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
License
RBT-22-238486 Issued in FL
Practice address
1210 N Hiatus Rd
Pembroke Pines, FL 33026-2720
Phone
(786) 877-3016
NPI assigned
Oct 24, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 24, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior TechnicianGroup: 193400000X SINGLE SPECIALTY GROUP 106S00000X RBT-22-238486 FL Primary

Addresses

Primary practice location

1210 N Hiatus Rd
Pembroke Pines, FL 33026-2720

Mailing address

1210 N Hiatus Rd
Pembroke Pines, FL 33026-2720
Phone (786) 877-3016

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
RBT-22-238486FLMDBehavior Technician

NPI Registry JSON

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

{
    "created_epoch": "1666569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666569600000",
    "number": "1407573264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1210 N HIATUS RD",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330262720",
            "telephone_number": "786-877-3016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1210 N HIATUS RD",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330262720",
            "telephone_number": "786-877-3016"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORENO ACANDA",
        "first_name": "ELVIS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-10-24",
        "last_updated": "2022-10-24",
        "certification_date": "2022-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Behavior Technician",
            "state": "FL",
            "license": "RBT-22-238486",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pembroke Pines, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2022; 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.