NPIMap

Individual provider Active NPI

Mercedes M Fuentes Vazquez

  • Assistant Behavior Analyst
  • Hialeah, FL
National Provider Identifier
1487205290
Registry record updated Jan 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assistant Behavior AnalystTaxonomy code 106E00000X
License
0-23-14956 Issued in FL
Practice address
1365 W 28TH St Apt 3NA
Hialeah, FL 33010-1036
Phone
(786) 346-9383
NPI assigned
Sep 23, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 3, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Assistant Behavior Analyst 106E00000X 0-23-14956 FL Primary
Behavior Technician 106S00000X RBT-19-99125 FL

Addresses

Primary practice location

1365 W 28TH St Apt 3NA
Hialeah, FL 33010-1036

Mailing address

1365 W 28TH St Apt 3
Hialeah, FL 33010-1036
Phone (786) 346-9383

Electronic endpoints 3

TypeEndpointUseAffiliation
CONNECT URL HIALEAH Other
CONNECT URL N/A Direct
CONNECT URL HIALEAH 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

State licenses

LicenseStateTypeSpecialty
RBT-19-99125FLMDBehavior Technician

Practice roles

OrganizationSpecialtyStatusNew patients
Brilliant Future LLC Behavior Technician CurrentSince Dec 24, 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": "1569196800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704240000000",
    "number": "1487205290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1365 W 28TH ST APT 3",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330101036",
            "telephone_number": "786-346-9383"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1365 W 28TH ST APT 3NA",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330101036",
            "telephone_number": "786-346-9383"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FUENTES VAZQUEZ",
        "first_name": "MERCEDES",
        "middle_name": "M",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-09-23",
        "last_updated": "2024-01-03",
        "certification_date": "2024-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106E00000X",
            "taxonomy_group": "",
            "desc": "Assistant Behavior Analyst",
            "state": "FL",
            "license": "0-23-14956",
            "primary": true
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "FL",
            "license": "RBT-19-99125",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "HIALEAH",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "HIALEAH",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "HIALEAH",
            "address_1": "81 E 61st St",
            "city": "Hialeah",
            "state": "FL",
            "country_code": "US",
            "postal_code": "330131022",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "N/A",
            "affiliation": "N",
            "endpointDescription": "N/A",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1365 W 28th St Apt 3Na",
            "city": "Hialeah",
            "state": "FL",
            "country_code": "US",
            "postal_code": "330101036",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "HIALEAH",
            "affiliation": "N",
            "endpointDescription": "HIALEAH",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1365 W 28th St Apt 3",
            "city": "Hialeah",
            "state": "FL",
            "country_code": "US",
            "postal_code": "330101036",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "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 Jan 3, 2024; 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.