Individual provider Active NPI

Glenda C Juarez

  • Early Intervention Provider Agency
  • Miami, FL
National Provider Identifier
1699178541
Registry record updated May 8, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Early Intervention Provider AgencyTaxonomy code 252Y00000X
License
590839562 Issued in FL
Practice address
18209 SW 114TH CT
Miami, FL 33157-4986
Phone
(305) 299-4360
NPI assigned
Oct 7, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 8, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X
Early Intervention Provider Agency 252Y00000X 590839562 FL Primary

Addresses

Primary practice location

18209 SW 114TH CT
Miami, FL 33157-4986

Mailing address

18209 SW 114TH CT
Miami, FL 33157-4986
Phone (305) 299-4360

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
590839562FLMDEarly Intervention Provider Agency

NPI Registry JSON

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

{
    "created_epoch": "1412640000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1525737600000",
    "number": "1699178541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18209 SW 114TH CT",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331574986",
            "telephone_number": "305-299-4360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18209 SW 114TH CT",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331574986",
            "telephone_number": "305-299-4360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JUAREZ",
        "first_name": "GLENDA",
        "middle_name": "C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-10-07",
        "last_updated": "2018-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": "FL",
            "license": "590839562",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2018; 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.