Individual provider Active NPI

Marelys Marques Gonzalez, RBT

  • Behavior Technician
  • Miami, FL
National Provider Identifier
1417571977
Registry record updated Jun 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
License
RBT-20-120189 Issued in FL
Practice address
6330 SW 92ND Ave
Miami, FL 33173-2439
Phone
(305) 608-3236
NPI assigned
Jun 1, 2020
Last updated
Jun 1, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 1, 2020

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 RBT-20-120189 FL Primary

Addresses

Primary practice location

6330 SW 92ND Ave
Miami, FL 33173-2439

Mailing address

6330 SW 92ND Ave
Miami, FL 33173-2439
Phone (305) 608-3236

Other identifiers 1

IdentifierTypeStateIssuer
M622-540-88-709-0MedicaidFL

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-20-120189FLMDBehavior Technician

NPI Registry JSON

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

{
    "created_epoch": "1590969600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590969600000",
    "number": "1417571977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6330 SW 92ND AVE",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331732439",
            "telephone_number": "305-608-3236"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6330 SW 92ND AVE",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331732439",
            "telephone_number": "305-608-3236"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARQUES GONZALEZ",
        "first_name": "MARELYS",
        "name_prefix": "Mrs.",
        "credential": "RBT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-06-01",
        "last_updated": "2020-06-01",
        "certification_date": "2020-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "FL",
            "license": "RBT-20-120189",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "M622-540-88-709-0",
            "state": "FL"
        }
    ],
    "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 Jun 1, 2020; 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.