Grethel Virginia Bolanos

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

Practice address

10200 NW 25TH St Ste 211
Doral, FL 33172-5927

Phone

(786) 317-4478

NPI assigned

Dec 5, 2017

Last updated

Jul 20, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1512432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689811200000",
    "number": "1548775141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1740 SW 87TH TER",
            "city": "MIRAMAR",
            "state": "FL",
            "postal_code": "330252025",
            "telephone_number": "305-469-9730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10200 NW 25TH ST STE 211",
            "city": "DORAL",
            "state": "FL",
            "postal_code": "331725927",
            "telephone_number": "786-317-4478"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLANOS",
        "first_name": "GRETHEL",
        "middle_name": "VIRGINIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-12-05",
        "last_updated": "2023-07-20",
        "certification_date": "2023-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "FL",
            "license": "RBT-18-74134",
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Fiorina Cecilia Boggiano, OTR/L
• Laura Bohorquez
• Boise Medical Center Inc
• Alejandra Boker, RD
• Haley C Bokros, DPT
• Lilliana Mercedes Bolanos
• Angelica Maria Bolivar de Briceno
• Jorge Mario Bolivar, APRN
• Sana Bolooki
• Roxana Bonachea, DMD

• 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 20, 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.