Active NPI
Rosanna Grullon
- Behavior Analyst
- Pembroke Pines, FL
National Provider Identifier
1417198060
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 1-13-14369
- Practice address
- 13000 SW 15TH CT Apt 309U
Pembroke Pines, FL 33027-2405 - Phone
- (305) 301-9509
- NPI assigned
- Mar 11, 2009
- 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 Analyst | 103K00000X | 1-13-14369 | FL | Primary |
Addresses
Primary practice location
13000 SW 15TH CT Apt 309U
Pembroke Pines, FL 33027-2405
Mailing address
1645 NE 168TH St
N Miami Beach, FL 33162-2934
Phone (305) 301-9509
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1236729600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1637539200000",
"number": "1417198060",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1645 NE 168TH ST",
"city": "N MIAMI BEACH",
"state": "FL",
"postal_code": "331622934",
"telephone_number": "305-301-9509"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13000 SW 15TH CT APT 309U",
"city": "PEMBROKE PINES",
"state": "FL",
"postal_code": "330272405",
"telephone_number": "305-301-9509"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRULLON",
"first_name": "ROSANNA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-03-11",
"last_updated": "2021-11-22",
"certification_date": "2021-11-22",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "FL",
"license": "1-13-14369",
"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 Nov 22, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.