Active NPI
Marvin Mervilus
- Behavior Technician
- Greenacres, FL
National Provider Identifier
1447911748
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- Practice address
- 6063 10TH Ave N
Greenacres, FL 33463-1629 - Phone
- (347) 765-7753
- NPI assigned
- Jan 7, 2022
- Last updated
- Jan 7, 2022
- Sex
- Male
- 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 Technician | 106S00000X | Primary |
Addresses
Primary practice location
6063 10TH Ave N
Greenacres, FL 33463-1629
Mailing address
6063 10TH Ave N
Greenacres, FL 33463-1629
Phone (347) 765-7753
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | MTMENTERPRISE2020@OUTLOOK.COM | Direct |
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": "1641513600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1641513600000",
"number": "1447911748",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6063 10TH AVE N",
"city": "GREENACRES",
"state": "FL",
"postal_code": "334631629",
"telephone_number": "347-765-7753"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6063 10TH AVE N",
"city": "GREENACRES",
"state": "FL",
"postal_code": "334631629",
"telephone_number": "347-765-7753"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MERVILUS",
"first_name": "MARVIN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2022-01-07",
"last_updated": "2022-01-07",
"certification_date": "2022-01-07",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "MTMENTERPRISE2020@OUTLOOK.COM",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "6063 10th Ave N",
"city": "Greenacres",
"state": "FL",
"country_code": "US",
"postal_code": "334631629",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Greenacres, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 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.