Individual provider Active NPI

Odiel Cribeiro Gordillo

  • Behavior Technician
  • Hialeah, FL
National Provider Identifier
1457960353
Registry record updated Jul 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
License
RBT-20-122854 Issued in FL
Practice address
18881 NW 88TH CT
Hialeah, FL 33018-6283
Phone
(786) 469-0042
NPI assigned
Jul 27, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 27, 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-20-122854 FL Primary

Addresses

Primary practice location

18881 NW 88TH CT
Hialeah, FL 33018-6283

Mailing address

18881 NW 88TH CT
Hialeah, FL 33018-6283
Phone (786) 469-0042

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-20-122854FLMDBehavior Technician

NPI Registry JSON

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

{
    "created_epoch": "1595808000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595808000000",
    "number": "1457960353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18881 NW 88TH CT",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330186283",
            "telephone_number": "786-469-0042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18881 NW 88TH CT",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330186283",
            "telephone_number": "786-469-0042"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRIBEIRO GORDILLO",
        "first_name": "ODIEL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-07-27",
        "last_updated": "2020-07-27",
        "certification_date": "2020-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "FL",
            "license": "RBT-20-122854",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hialeah, FL

Sources for this page

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