Early Intervention Program LLC

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

Legal business name

EARLY INTERVENTION PROGRAM LLC

Practice address

3625 NW 82ND Ave Ste N
Doral, FL 33166-6652

Phone

(786) 615-2890

Fax

(305) 381-5119

NPI assigned

Nov 4, 2021

Last updated

Jul 15, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Angela TejedaNPI 1588249064

Title

Ceo

Phone

(786) 643-7819

Specialties & licenses 2

Addresses

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Angela I Tejeda

  • Psychologist
  • Doral, FL
  • NPI 1588249064
  NPD Authorized official
• Asyah Myers

  • Occupational Therapy Assistant
  • North Miami, FL
  • NPI 1285395558
  NPD (past)

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

{
    "created_epoch": "1635984000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1657843200000",
    "number": "1538824545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3625 NW 82ND AVE STE ZZ",
            "city": "DORAL",
            "state": "FL",
            "postal_code": "331666652",
            "telephone_number": "786-643-7819"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3625 NW 82ND AVE STE N",
            "city": "DORAL",
            "state": "FL",
            "postal_code": "331666652",
            "telephone_number": "786-615-2890",
            "fax_number": "305-381-5119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EARLY INTERVENTION PROGRAM LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-11-04",
        "last_updated": "2022-07-15",
        "certification_date": "2022-07-15",
        "status": "A",
        "authorized_official_last_name": "TEJEDA",
        "authorized_official_first_name": "ANGELA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "786-643-7819"
    },
    "taxonomies": [
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Behavior Analyst in Doral, FL
• Providers in Doral, FL by specialty
• Behavior Analyst in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2022; 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.