Penny-Lane Xanadu Ballester

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

Practice address

21352 SW 112TH Ave Apt 205
Cutler Bay, FL 33189-2969

Phone

(305) 458-6868

NPI assigned

Jun 5, 2020

Last updated

Jun 5, 2020By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1591315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591315200000",
    "number": "1609490523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21352 SW 112TH AVE APT 205",
            "city": "CUTLER BAY",
            "state": "FL",
            "postal_code": "331892969",
            "telephone_number": "305-458-6868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21352 SW 112TH AVE APT 205",
            "city": "CUTLER BAY",
            "state": "FL",
            "postal_code": "331892969",
            "telephone_number": "305-458-6868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALLESTER",
        "first_name": "PENNY-LANE",
        "middle_name": "XANADU",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-06-05",
        "last_updated": "2020-06-05",
        "certification_date": "2020-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael Baez
• Maximillion Bahamundi, RBT
• Briana Beatriz Bailon, RBT
• Mayren Balaguer Mederos
• Yenima Baldrich
• Anaisys M Ballesteros, D.O.
• Bamboo Behavioral Services LLC
• Arturo Banos
• Banyan Community Health Center, Inc.
• Banyan Community Health Center, Inc.

• Behavior Technician in Cutler Bay, FL
• Providers in Cutler Bay, FL by specialty
• Behavior Technician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 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.