Individual provider Active NPI

Yairsa Fayula Sarmientos

  • Behavior Analyst
  • Fort Lauderdale, FL
National Provider Identifier
1659801777
Registry record updated Jun 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1-23-66392 Issued in FL
Practice address
1051 NW 45TH St
Fort Lauderdale, FL 33309-3822
Phone
(786) 702-7484
NPI assigned
Jun 13, 2017
Last updated
Jun 22, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 22, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X 1-23-66392 FL Primary
Assistant Behavior Analyst 106E00000X 0-21-12166 FL
Behavior Technician 106S00000X NU

Addresses

Primary practice location

1051 NW 45TH St
Fort Lauderdale, FL 33309-3822

Mailing address

1051 NW 45TH St
Fort Lauderdale, FL 33309-3822
Phone (786) 702-7484

Other identifiers 1

IdentifierTypeStateIssuer
670412MedicaidFL

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
Children's Love Corporation Current Accepting new patients
Children's Love Corporation Behavior Analyst CurrentSince Nov 1, 2022 Accepting new patients

Locations

14902 Winding Creek Ct
Ste 104C
Tampa, FL 33613
Phone (561) 270-0220

8875 Hidden River Pkwy
Ste 356
Tampa, FL 33637

Organizations & group practices 2

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": "1497312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687392000000",
    "number": "1659801777",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1051 NW 45TH ST",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333093822",
            "telephone_number": "786-702-7484"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1051 NW 45TH ST",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333093822",
            "telephone_number": "786-702-7484"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAYULA SARMIENTOS",
        "first_name": "YAIRSA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-06-13",
        "last_updated": "2023-06-22",
        "certification_date": "2023-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "FL",
            "license": "1-23-66392",
            "primary": true
        },
        {
            "code": "106E00000X",
            "taxonomy_group": "",
            "desc": "Assistant Behavior Analyst",
            "state": "FL",
            "license": "0-21-12166",
            "primary": false
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "670412",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Lauderdale, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2023; 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.