Individual provider Active NPI

Raiza M Fernandez

  • Behavior Technician
  • Homestead, FL
National Provider Identifier
1679921985
Registry record updated Nov 5, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
Practice address
1428 E Mowry Dr Apt 103
Homestead, FL 33033-4955
Phone
(305) 632-0931
NPI assigned
May 26, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 5, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
In Home Supportive Care Agency 253Z00000X
Behavior Technician 106S00000X Primary

Addresses

Primary practice location

1428 E Mowry Dr Apt 103
Homestead, FL 33033-4955

Mailing address

29120 SW 147TH Ave
Homestead, FL 33033-2760

Other practice location 1

10700 Caribbean Blvd Ste 101
Cutler Bay, FL 33189-1224
Phone (786) 713-0158

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
Psychological & Behavioral Services, Inc. In Home Supportive Care PastSince Aug 29, 2021 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1464220800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572912000000",
    "number": "1679921985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29120 SW 147TH AVE",
            "city": "HOMESTEAD",
            "state": "FL",
            "postal_code": "330332760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1428 E MOWRY DR APT 103",
            "city": "HOMESTEAD",
            "state": "FL",
            "postal_code": "330334955",
            "telephone_number": "305-632-0931"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10700 Caribbean Blvd Ste 101",
            "address_purpose": "LOCATION",
            "city": "Cutler Bay",
            "state": "FL",
            "postal_code": "331891224",
            "country_code": "US",
            "telephone_number": "786-713-0158",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FERNANDEZ",
        "first_name": "RAIZA",
        "middle_name": "M",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-05-26",
        "last_updated": "2019-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Nov 5, 2019; 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.