Mirna Carolina Pacheco Caceres

Primary specialty

Assistant Behavior AnalystTaxonomy code 106E00000X

License

0-24-15262 Issued in FL

Practice address

5911 NW 173Rd Dr Unit 11
Hialeah, FL 33015-5122

Phone

(786) 803-0112

NPI assigned

Nov 1, 2017

Last updated

Jul 15, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Locations

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.

• Ark Provision Enterprises, Inc.

  • Developmental Disabilities Clinic/Center
  • Hialeah, FL
  • NPI 1013683440
  NPD
• Ark Provision Enterprises, Inc.

  • Behavior Analyst
  • Hialeah, FL
  • NPI 1598120156
  NPD
• Behavioral Advancement Therapy Corp

  • Behavior Analyst
  • Miami, FL
  • NPI 1497476840
  NPD (past)

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

{
    "created_epoch": "1509494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721001600000",
    "number": "1659883577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 W 31ST ST APT 101",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330125463",
            "telephone_number": "786-803-0112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5911 NW 173RD DR UNIT 11",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330155122",
            "telephone_number": "786-803-0112"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3090 Palm Ave Apt 8",
            "address_purpose": "LOCATION",
            "city": "Hialeah",
            "state": "FL",
            "postal_code": "330125457",
            "country_code": "US",
            "telephone_number": "786-803-0112",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2100 W 76th St Ste 411",
            "address_purpose": "LOCATION",
            "city": "Hialeah",
            "state": "FL",
            "postal_code": "330165504",
            "country_code": "US",
            "telephone_number": "786-655-9992",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "50 W 31st St Apt 101",
            "address_purpose": "LOCATION",
            "city": "Hialeah",
            "state": "FL",
            "postal_code": "330125463",
            "country_code": "US",
            "telephone_number": "786-803-0112",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PACHECO CACERES",
        "first_name": "MIRNA",
        "middle_name": "CAROLINA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-11-01",
        "last_updated": "2024-07-15",
        "certification_date": "2024-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106E00000X",
            "taxonomy_group": "",
            "desc": "Assistant Behavior Analyst",
            "state": "FL",
            "license": "0-24-15262",
            "primary": true
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "022835800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Pac Medical Center
• Pac Medical Center LLC
• Pac Medical Services Corp
• Gabriel Pacareu
• Pacer Medical Supplies Corp.
• Maria V Pacheco Perez
• Valentina Del Valle Pacheco Perez
• Fernando Pacheco Pineyro
• Mayrelis Pacheco Serrano
• Emelia Pacheco Suarez

• Assistant Behavior Analyst in Hialeah, FL
• Providers in Hialeah, FL by specialty
• Assistant Behavior Analyst in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 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.

Verify at the official NPI Registry.