Act Florida, LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

ACT FLORIDA, LLC

Practice address

12505 Orange Dr Ste 908
Davie, FL 33330-4300

Phone

(786) 306-0505

NPI assigned

Oct 31, 2020

Last updated

Oct 31, 2020By 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

Ms. Yaimara Sanchez Caballero

Title

Manager

Phone

(786) 306-0505

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Locations

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

{
    "created_epoch": "1604102400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1604102400000",
    "number": "1548860109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2413 MAIN ST # 326",
            "city": "MIRAMAR",
            "state": "FL",
            "postal_code": "330257809",
            "telephone_number": "786-306-0505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12505 ORANGE DR STE 908",
            "city": "DAVIE",
            "state": "FL",
            "postal_code": "333304300",
            "telephone_number": "786-306-0505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACT FLORIDA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-31",
        "last_updated": "2020-10-31",
        "certification_date": "2020-10-31",
        "status": "A",
        "authorized_official_last_name": "SANCHEZ CABALLERO",
        "authorized_official_first_name": "YAIMARA",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "786-306-0505",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "023444500",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "www.simplepractice.com",
            "affiliation": "N",
            "address_1": "12505 Orange Dr Ste 908",
            "city": "Davie",
            "state": "FL",
            "country_code": "US",
            "postal_code": "333304300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 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.