Individual provider Active NPI

Stephanie Quintero

  • Behavior Analyst
  • Pembroke Pines, FL
National Provider Identifier
1629528401
Registry record updated Sep 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Practice address
17773 SW 2ND St
Pembroke Pines, FL 33029-3924
Phone
(954) 589-2347
NPI assigned
Oct 5, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 8, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X Primary

Addresses

Primary practice location

17773 SW 2ND St
Pembroke Pines, FL 33029-3924

Mailing address

8001 SW 36TH St
Suite 9
Davie, FL 33328-1915
Phone (954) 577-7790

Other practice location 1

8001 SW 36th St
Suite 9
Davie, FL 33328-1915
Phone (954) 577-7790

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

Practice roles

OrganizationSpecialtyStatusNew patients
Evolving Minds Together LLC CurrentSince Sep 11, 2022 Accepting new patients

Locations

17773 SW 2nd St
Pembroke Pines, FL 33029
Phone (954) 589-2347

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1475625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662595200000",
    "number": "1629528401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8001 SW 36TH ST",
            "address_2": "SUITE 9",
            "city": "DAVIE",
            "state": "FL",
            "postal_code": "333281915",
            "telephone_number": "954-577-7790",
            "fax_number": "954-577-7780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17773 SW 2ND ST",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330293924",
            "telephone_number": "954-589-2347"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8001 SW 36th St",
            "address_2": "Suite 9",
            "address_purpose": "LOCATION",
            "city": "Davie",
            "state": "FL",
            "postal_code": "333281915",
            "country_code": "US",
            "telephone_number": "954-577-7790",
            "fax_number": "954-577-7780",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "QUINTERO",
        "first_name": "STEPHANIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-10-05",
        "last_updated": "2022-09-08",
        "certification_date": "2022-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "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 Sep 8, 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.