Active NPI
Yandry Gutierrez Rivero
- Behavior Technician
- Boynton Beach, FL
National Provider Identifier
1619702578
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- BACB1149377
- Practice address
- 4793 N Congress Ave Ste 203-204
Boynton Beach, FL 33426-7937 - Phone
- (561) 429-3863
- NPI assigned
- Sep 2, 2024
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | BACB1149377 | FL | Primary |
Addresses
Primary practice location
4793 N Congress Ave Ste 203-204
Boynton Beach, FL 33426-7937
Mailing address
441 Broward Ave
Greenacres, FL 33463-2001
Phone (561) 654-3933
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
| License | State | Type | Specialty |
|---|---|---|---|
| BACB1149377 | FL | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1725235200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1725235200000",
"number": "1619702578",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "441 BROWARD AVE",
"city": "GREENACRES",
"state": "FL",
"postal_code": "334632001",
"telephone_number": "561-654-3933"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4793 N CONGRESS AVE STE 203-204",
"city": "BOYNTON BEACH",
"state": "FL",
"postal_code": "334267937",
"telephone_number": "561-429-3863"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GUTIERREZ RIVERO",
"first_name": "YANDRY",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2024-09-02",
"last_updated": "2024-09-02",
"certification_date": "2024-09-02",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "FL",
"license": "BACB1149377",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Boynton Beach, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.