Individual provider Active NPI

Nivio Olivera Lopez

  • Behavior Technician
  • Homestead, FL
National Provider Identifier
1659902039
Registry record updated Apr 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
License
RBT-20-111748 Issued in FL
Practice address
13460 SW 276TH St
Homestead, FL 33032-3210
Phone
(786) 222-3159
NPI assigned
Feb 4, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 23, 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 RBT-20-111748 FL Primary

Addresses

Primary practice location

13460 SW 276TH St
Homestead, FL 33032-3210

Mailing address

13460 SW 276TH St
Homestead, FL 33032-3210
Phone (786) 222-3159

Other practice location 1

11902 SW 196th Ter
Miami, FL 33177-4361
Phone (786) 222-3159

Other identifiers 1

IdentifierTypeStateIssuer
105460500MedicaidFL

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-20-111748FLMDBehavior Technician

NPI Registry JSON

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

{
    "created_epoch": "1580774400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587600000000",
    "number": "1659902039",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13460 SW 276TH ST",
            "city": "HOMESTEAD",
            "state": "FL",
            "postal_code": "330323210",
            "telephone_number": "786-222-3159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13460 SW 276TH ST",
            "city": "HOMESTEAD",
            "state": "FL",
            "postal_code": "330323210",
            "telephone_number": "786-222-3159"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11902 SW 196th Ter",
            "address_purpose": "LOCATION",
            "city": "Miami",
            "state": "FL",
            "postal_code": "331774361",
            "country_code": "US",
            "telephone_number": "786-222-3159",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OLIVERA LOPEZ",
        "first_name": "NIVIO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-02-04",
        "last_updated": "2020-04-23",
        "certification_date": "2020-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "FL",
            "license": "RBT-20-111748",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "105460500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Homestead, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 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.