Active NPI
Mario Patterson
- Behavior Technician
- Homestead, FL
National Provider Identifier
1689230336
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- RBT-19-80336
- Practice address
- 654 NE 9TH PL
Homestead, FL 33030-4934 - Phone
- (305) 248-3488
- Fax
- (305) 248-6558
- NPI assigned
- May 17, 2019
- 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 | RBT-19-80336 | FL | Primary |
Addresses
Primary practice location
654 NE 9TH PL
Homestead, FL 33030-4934
Mailing address
32151 SW 197TH Ave
Homestead, FL 33030-6406
Phone (786) 582-0609
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| RBT-19-80336 | Other | FL | RBT CERTIFICATION |
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 |
|---|---|---|---|
| RBT-19-80336 | FL | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1558051200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1559088000000",
"number": "1689230336",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "32151 SW 197TH AVE",
"city": "HOMESTEAD",
"state": "FL",
"postal_code": "330306406",
"telephone_number": "786-582-0609"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "654 NE 9TH PL",
"city": "HOMESTEAD",
"state": "FL",
"postal_code": "330304934",
"telephone_number": "305-248-3488",
"fax_number": "305-248-6558"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PATTERSON",
"first_name": "MARIO",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2019-05-17",
"last_updated": "2019-05-29",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Behavior Technician",
"state": "FL",
"license": "RBT-19-80336",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RBT CERTIFICATION",
"identifier": "RBT-19-80336",
"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 May 29, 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.