Active NPI
Edgar Jose Sotillo, RBT
- Behavior Technician
- Coconut Creek, FL
National Provider Identifier
1649090994
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- RBT-24-379280
- Practice address
- 5480 Lyons Rd
Coconut Creek, FL 33073-2812 - Phone
- (954) 495-0254
- NPI assigned
- Oct 11, 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 | RBT-24-379280 | FL | Primary |
Addresses
Primary practice location
5480 Lyons Rd
Coconut Creek, FL 33073-2812
Mailing address
5480 Lyons Rd
Coconut Creek, FL 33073-2812
Phone (954) 495-0254
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 |
|---|---|---|---|
| RBT-24-379280 | FL | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1728604800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1728604800000",
"number": "1649090994",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5480 LYONS RD",
"city": "COCONUT CREEK",
"state": "FL",
"postal_code": "330732812",
"telephone_number": "954-495-0254"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5480 LYONS RD",
"city": "COCONUT CREEK",
"state": "FL",
"postal_code": "330732812",
"telephone_number": "954-495-0254"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SOTILLO",
"first_name": "EDGAR",
"middle_name": "JOSE",
"credential": "RBT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2024-10-11",
"last_updated": "2024-10-11",
"certification_date": "2024-10-11",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "FL",
"license": "RBT-24-379280",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 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.