Individual provider Active NPI

Eboni Michelle Burden

  • Behavior Technician
  • Pembroke Pines, FL
National Provider Identifier
1417581273
Registry record updated Mar 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
License
RBT-17-40254 Issued in FL
Practice address
10261 Pines Blvd
Pembroke Pines, FL 33026-6008
Phone
(954) 356-2878
NPI assigned
Mar 2, 2020
Last updated
Mar 2, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 2, 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-17-40254 FL Primary

Addresses

Primary practice location

10261 Pines Blvd
Pembroke Pines, FL 33026-6008

Mailing address

10261 Pines Blvd
Pembroke Pines, FL 33026-6008

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-17-40254FLMDBehavior Technician

NPI Registry JSON

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

{
    "created_epoch": "1583107200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583107200000",
    "number": "1417581273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10261 PINES BLVD",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330266008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10261 PINES BLVD",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330266008",
            "telephone_number": "954-356-2878"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURDEN",
        "first_name": "EBONI",
        "middle_name": "MICHELLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-02",
        "last_updated": "2020-03-02",
        "certification_date": "2020-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "FL",
            "license": "RBT-17-40254",
            "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 Mar 2, 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.