Individual provider Active NPI

Rocio Esmeralda Fernandez Mora

  • Behavior Technician
  • Pembroke Pines, FL
National Provider Identifier
1558093971
Registry record updated Jun 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
License
RBT-22-215665 Issued in FL
Practice address
701 Promenade Dr Ste 250
Pembroke Pines, FL 33026-6035
Phone
(954) 399-2637
NPI assigned
Jun 24, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2022

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-22-215665 FL Primary

Addresses

Primary practice location

701 Promenade Dr Ste 250
Pembroke Pines, FL 33026-6035

Mailing address

20040 NW 3Rd CT
Miami Gardens, FL 33169-2916
Phone (786) 378-2640

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL Kelin@equanimitytherapy.com

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-22-215665FLMDBehavior Technician

NPI Registry JSON

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

{
    "created_epoch": "1656028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656028800000",
    "number": "1558093971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20040 NW 3RD CT",
            "city": "MIAMI GARDENS",
            "state": "FL",
            "postal_code": "331692916",
            "telephone_number": "786-378-2640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 PROMENADE DR STE 250",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330266035",
            "telephone_number": "954-399-2637"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERNANDEZ MORA",
        "first_name": "ROCIO",
        "middle_name": "ESMERALDA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-24",
        "last_updated": "2022-06-24",
        "certification_date": "2022-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "FL",
            "license": "RBT-22-215665",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Kelin@equanimitytherapy.com",
            "affiliation": "N",
            "address_1": "701 Promenade Dr Ste 250",
            "city": "Pembroke Pines",
            "state": "FL",
            "country_code": "US",
            "postal_code": "330266035",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Pembroke Pines, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 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.