NPIMap

Organization Active NPI

Therapeutic Rebirth Corporation

  • Behavior Analyst
  • Miami, FL
National Provider Identifier
1619497609
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
MH7550 Issued in FL
Legal business name
THERAPEUTIC REBIRTH CORPORATION
Practice address
4310 SW 164TH CT
Miami, FL 33185-5293
Phone
(305) 905-0631
NPI assigned
Jun 21, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Mr. Eduardo Alvarez, LMHCNPI 1821493214
Title
President
Phone
(305) 905-0631

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior AnalystGroup: 193200000X MULTI-SPECIALTY GROUP 103K00000X MH7550 FL Primary
Developmental Disabilities Clinic/Center 261QD1600X MH7550 FL
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X MH7550 FL

Addresses

Primary practice location

4310 SW 164TH CT
Miami, FL 33185-5293

Mailing address

4310 SW 164TH CT
Miami, FL 33185-5293
Phone (305) 905-0631

Other identifiers 1

IdentifierTypeStateIssuer
017436200MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20241114002447 FL Part B Supplier - Clinic/Group Practice 5890229769 Receives reassigned benefits from 1 practitioner
Practice locations: Miami, FL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1498003200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1619497609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4310 SW 164TH CT",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331855293",
            "telephone_number": "305-905-0631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4310 SW 164TH CT",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331855293",
            "telephone_number": "305-905-0631"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THERAPEUTIC REBIRTH CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-06-21",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "ALVAREZ",
        "authorized_official_first_name": "EDUARDO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "305-905-0631",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LMHC"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Behavior Analyst",
            "state": "FL",
            "license": "MH7550",
            "primary": true
        },
        {
            "code": "261QD1600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Developmental Disabilities",
            "state": "FL",
            "license": "MH7550",
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "FL",
            "license": "MH7550",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "017436200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.