Individual provider Active NPI

Mayelin V Bobadilla

  • Behavior Technician
  • Greenacres, FL
National Provider Identifier
1518425180
Registry record updated Dec 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
License
RBT-20125342 Issued in FL
Practice address
6415 Lake Worth Rd Ste 204
Greenacres, FL 33463-2904
Phone
(561) 771-9561
Fax
(800) 766-3139
NPI assigned
Mar 3, 2019
Last updated
Dec 18, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 18, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Assistant 2355S0801X SI3932 FL
Behavior Technician 106S00000X RBT-20125342 FL Primary

Addresses

Primary practice location

6415 Lake Worth Rd Ste 204
Greenacres, FL 33463-2904

Mailing address

101 Tropical Ave
West Palm Beach, FL 33415-1943
Phone (305) 458-3017

Other identifiers 1

IdentifierTypeStateIssuer
109645700MedicaidFL

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-20125342FLMDBehavior Technician
SI3932FLMDSpeech-Language Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
First Words Pediatric Therapy Past 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1551571200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734480000000",
    "number": "1518425180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 TROPICAL AVE",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334151943",
            "telephone_number": "305-458-3017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6415 LAKE WORTH RD STE 204",
            "city": "GREENACRES",
            "state": "FL",
            "postal_code": "334632904",
            "telephone_number": "561-771-9561",
            "fax_number": "800-766-3139"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOBADILLA",
        "first_name": "MAYELIN",
        "middle_name": "V",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-03-03",
        "last_updated": "2024-12-18",
        "certification_date": "2024-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2355S0801X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Speech-Language Assistant",
            "state": "FL",
            "license": "SI3932",
            "primary": false
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "FL",
            "license": "RBT-20125342",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "109645700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenacres, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 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.