Active NPI
Daniel Medina
- Behavior Technician
- Doral, FL
National Provider Identifier
1679270938
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- 23-252480
- Practice address
- 8323 NW 12TH St Ste 216
Doral, FL 33126-1840 - Phone
- (305) 224-1929
- NPI assigned
- Feb 7, 2023
- 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 | 23-252480 | FL | Primary |
Addresses
Primary practice location
8323 NW 12TH St Ste 216
Doral, FL 33126-1840
Mailing address
12523 SW 27TH St
Miami, FL 33175-2108
Phone (305) 812-0436
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| M350-160-99-062-0 | Other | FL | DRIVER LISCENSE |
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 |
|---|---|---|---|
| 23-252480 | FL | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1675728000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1675728000000",
"number": "1679270938",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12523 SW 27TH ST",
"city": "MIAMI",
"state": "FL",
"postal_code": "331752108",
"telephone_number": "305-812-0436"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8323 NW 12TH ST STE 216",
"city": "DORAL",
"state": "FL",
"postal_code": "331261840",
"telephone_number": "305-224-1929"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MEDINA",
"first_name": "DANIEL",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2023-02-07",
"last_updated": "2023-02-07",
"certification_date": "2023-02-07",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "FL",
"license": "23-252480",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DRIVER LISCENSE",
"identifier": "M350-160-99-062-0",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Doral, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 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.