Individual provider Active NPI

Innia Suley Pereira

  • Assistant Behavior Analyst
  • North Miami Beach, FL
National Provider Identifier
1497287247
Registry record updated Sep 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assistant Behavior AnalystTaxonomy code 106E00000X
License
0-20-11036 Issued in FL
Practice address
16201 NE 13TH Ave
North Miami Beach, FL 33162-4607
Phone
(786) 955-6224
NPI assigned
Mar 31, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 30, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Assistant Behavior AnalystGroup: 193400000X SINGLE SPECIALTY GROUP 106E00000X 0-20-11036 FL Primary
Behavior Technician 106S00000X 18-65677 FL

Addresses

Primary practice location

16201 NE 13TH Ave
North Miami Beach, FL 33162-4607

Mailing address

16201 NE 13TH Ave
North Miami Beach, FL 33162-4607
Phone (786) 955-6224

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
18-65677FLMDBehavior Technician

Practice roles

OrganizationSpecialtyStatusNew patients
Crystal Kids Development Center Single Specialty Current Accepting new patients
SK ABA Center Corp Current Accepting new patients

Locations

16201 NE 13th Ave
North Miami Beach, FL 33162
Phone (305) 952-3161

Organizations & group practices 2

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": "1490918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601424000000",
    "number": "1497287247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16201 NE 13TH AVE",
            "city": "NORTH MIAMI BEACH",
            "state": "FL",
            "postal_code": "331624607",
            "telephone_number": "786-955-6224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16201 NE 13TH AVE",
            "city": "NORTH MIAMI BEACH",
            "state": "FL",
            "postal_code": "331624607",
            "telephone_number": "786-955-6224"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEREIRA",
        "first_name": "INNIA",
        "middle_name": "SULEY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-03-31",
        "last_updated": "2020-09-30",
        "certification_date": "2020-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Assistant Behavior Analyst",
            "state": "FL",
            "license": "0-20-11036",
            "primary": true
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "FL",
            "license": "18-65677",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Miami Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 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.