Individual provider Active NPI

Erick Castillo Jimenez

  • Behavior Technician
  • Miami, FL
National Provider Identifier
1649876293
Registry record updated Dec 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
License
20-129300 Issued in FL
Practice address
4732 SW 136TH PL
Miami, FL 33175-5131
Phone
(786) 479-7017
NPI assigned
Dec 9, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 9, 2020

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 20-129300 FL Primary

Addresses

Primary practice location

4732 SW 136TH PL
Miami, FL 33175-5131

Mailing address

4732 SW 136TH PL
Miami, FL 33175-5131
Phone (786) 479-7017

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
20-129300FLMDBehavior Technician

NPI Registry JSON

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

{
    "created_epoch": "1607472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607472000000",
    "number": "1649876293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4732 SW 136TH PL",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331755131",
            "telephone_number": "786-479-7017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4732 SW 136TH PL",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331755131",
            "telephone_number": "786-479-7017"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CASTILLO JIMENEZ",
        "first_name": "ERICK",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-12-09",
        "last_updated": "2020-12-09",
        "certification_date": "2020-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "FL",
            "license": "20-129300",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Dec 9, 2020; 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.