Individual provider Active NPI

Irasel Mesa, R.B.T

  • Behavior Technician
  • Miami, FL
National Provider Identifier
1447914783
Registry record updated Oct 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
License
102912500 Issued in FL
Practice address
4051 SW 154TH CT
Miami, FL 33185-5416
Phone
(786) 603-9158
NPI assigned
Oct 22, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 22, 2021

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 102912500 FL Primary

Addresses

Primary practice location

4051 SW 154TH CT
Miami, FL 33185-5416

Mailing address

4051 SW 154TH CT
Miami, FL 33185-5416
Phone (786) 603-9158

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
102912500FLMDBehavior Technician

NPI Registry JSON

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

{
    "created_epoch": "1634860800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634860800000",
    "number": "1447914783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4051 SW 154TH CT",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331855416",
            "telephone_number": "786-603-9158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4051 SW 154TH CT",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331855416",
            "telephone_number": "786-603-9158"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MESA",
        "first_name": "IRASEL",
        "credential": "R.B.T",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-10-22",
        "last_updated": "2021-10-22",
        "certification_date": "2021-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "FL",
            "license": "102912500",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Oct 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.

Verify at the official NPI Registry.