Individual provider Active NPI

Maelis De Los Angeles Sosa Fundora

  • Behavior Technician
  • Miami, FL
National Provider Identifier
1518735372
Registry record updated Dec 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
License
RBT-23-307623 Issued in FL
Practice address
17137 SW 112TH CT
Miami, FL 33157-3906
Phone
(786) 727-3918
NPI assigned
Dec 12, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 12, 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-23-307623 FL Primary

Addresses

Primary practice location

17137 SW 112TH CT
Miami, FL 33157-3906

Mailing address

17137 SW 112TH CT
Miami, FL 33157-3906
Phone (786) 727-3918

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-23-307623FLMDBehavior Technician

NPI Registry JSON

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

{
    "created_epoch": "1702339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702339200000",
    "number": "1518735372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17137 SW 112TH CT",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331573906",
            "telephone_number": "786-727-3918"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17137 SW 112TH CT",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331573906",
            "telephone_number": "786-727-3918"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOSA FUNDORA",
        "first_name": "MAELIS",
        "middle_name": "DE LOS ANGELES",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-12-12",
        "last_updated": "2023-12-12",
        "certification_date": "2023-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "FL",
            "license": "RBT-23-307623",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 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.