NPIMap

Organization Active NPI

Neuroedge Psychology LLC

  • Behavior Analyst
  • Hialeah, FL
National Provider Identifier
1700403672
Registry record updated Jun 26, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Legal business name
NEUROEDGE PSYCHOLOGY LLC
Practice address
3373 W 90TH St
Hialeah, FL 33018-2005
Phone
(786) 442-5424
NPI assigned
Jun 26, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2020

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

Authorized official

Name
Gendry MontesinoNPI 1003162363
Title
Ceo
Phone
(786) 442-5424

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior AnalystGroup: 193400000X SINGLE SPECIALTY GROUP 103K00000X Primary

Addresses

Primary practice location

3373 W 90TH St
Hialeah, FL 33018-2005

Mailing address

3373 W 90TH St
Hialeah, FL 33018-2005
Phone (786) 442-5424

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1593129600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1593129600000",
    "number": "1700403672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3373 W 90TH ST",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330182005",
            "telephone_number": "786-442-5424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3373 W 90TH ST",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330182005",
            "telephone_number": "786-442-5424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEUROEDGE PSYCHOLOGY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-06-26",
        "last_updated": "2020-06-26",
        "certification_date": "2020-06-26",
        "status": "A",
        "authorized_official_last_name": "MONTESINO",
        "authorized_official_first_name": "GENDRY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "786-442-5424"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hialeah, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 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.