Active NPI
Kelvin James Pinero III
- Behavior Technician
- Doral, FL
National Provider Identifier
1700573136
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- 23264895
- Practice address
- 6055 NW 104TH Ave Ste 1
Doral, FL 33178-4867 - Phone
- (954) 829-7866
- NPI assigned
- Apr 18, 2023
- Sex
- Male
- Sole proprietor
- No
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 | 23264895 | FL | Primary |
Addresses
Primary practice location
6055 NW 104TH Ave Ste 1
Doral, FL 33178-4867
Mailing address
10500 SW 108TH Ave Apt B406
Miami, FL 33176-8608
Phone (954) 829-7866
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 |
|---|---|---|---|
| 23264895 | FL | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1681776000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1681776000000",
"number": "1700573136",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10500 SW 108TH AVE APT B406",
"city": "MIAMI",
"state": "FL",
"postal_code": "331768608",
"telephone_number": "954-829-7866"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6055 NW 104TH AVE STE 1",
"city": "DORAL",
"state": "FL",
"postal_code": "331784867",
"telephone_number": "954-829-7866"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PINERO",
"first_name": "KELVIN",
"middle_name": "JAMES",
"name_suffix": "III",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-04-18",
"last_updated": "2023-04-18",
"certification_date": "2023-04-17",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "FL",
"license": "23264895",
"primary": true
}
],
"identifiers": [],
"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 Apr 18, 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.