Individual provider Active NPI

Maria Carla Fernandez Montejo

  • Behavior Technician
  • Pembroke Pines, FL
National Provider Identifier
1639793490
Registry record updated Sep 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
License
RBT-19-102438 Issued in FL
Practice address
2121 NW 96TH Ter Apt 14N
Pembroke Pines, FL 33024-3040
Phone
(305) 497-8760
NPI assigned
Jun 7, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 23, 2021

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-19-102438 FL Primary

Addresses

Primary practice location

2121 NW 96TH Ter Apt 14N
Pembroke Pines, FL 33024-3040

Mailing address

2121 NW 96TH Ter Apt 14N
Pembroke Pines, FL 33024-3040
Phone (305) 497-8760

Other identifiers 1

IdentifierTypeStateIssuer
106584300MedicaidFL

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-19-102438FLMDBehavior Technician

Practice roles

OrganizationSpecialtyStatusNew patients
Better Future Behavioral Therapy PastSince Jun 1, 2020 Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1591488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632355200000",
    "number": "1639793490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2121 NW 96TH TER APT 14N",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330243040",
            "telephone_number": "305-497-8760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2121 NW 96TH TER APT 14N",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330243040",
            "telephone_number": "305-497-8760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERNANDEZ MONTEJO",
        "first_name": "MARIA",
        "middle_name": "CARLA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-06-07",
        "last_updated": "2021-09-23",
        "certification_date": "2021-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "FL",
            "license": "RBT-19-102438",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "106584300",
            "state": "FL"
        }
    ],
    "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 23, 2021; 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.