Individual provider Active NPI

Reny Anthony Santiesteban Sr.

  • Behavior Technician
  • Miami Lakes, FL
National Provider Identifier
1457055295
Registry record updated Mar 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
License
RBT-23-259368 Issued in FL
Practice address
6625 Miami Lakes Dr Ste 338
Miami Lakes, FL 33014-2705
Phone
(305) 777-3852
NPI assigned
Mar 27, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 27, 2023

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-23-259368 FL Primary

Addresses

Primary practice location

6625 Miami Lakes Dr Ste 338
Miami Lakes, FL 33014-2705

Mailing address

440 E 23Rd St Apt 1402
Hialeah, FL 33013-3940
Phone (786) 339-4882

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-23-259368FLMDBehavior Technician

Practice roles

OrganizationSpecialtyStatusNew patients
Positive Minds Behavior Group, LLC Dba Positive Minds Rehabilitation Center PastSince Apr 6, 2023 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1679875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679875200000",
    "number": "1457055295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "440 E 23RD ST APT 1402",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330133940",
            "telephone_number": "786-339-4882"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6625 MIAMI LAKES DR STE 338",
            "city": "MIAMI LAKES",
            "state": "FL",
            "postal_code": "330142705",
            "telephone_number": "305-777-3852"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANTIESTEBAN",
        "first_name": "RENY",
        "middle_name": "ANTHONY",
        "name_prefix": "Mr.",
        "name_suffix": "Sr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-03-27",
        "last_updated": "2023-03-27",
        "certification_date": "2023-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "FL",
            "license": "RBT-23-259368",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami Lakes, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2023; 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.