Individual provider Active NPI

Kimora Claude Coreus

  • Behavior Technician
  • Lauderdale Lakes, FL
National Provider Identifier
1700692696
Registry record updated Dec 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
License
RBT-24-369124 Issued in FL
Practice address
3471 NW 43Rd PL
Lauderdale Lakes, FL 33309-4240
Phone
(754) 971-1722
NPI assigned
Dec 5, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X RBT-24-369124 FL Primary

Addresses

Primary practice location

3471 NW 43Rd PL
Lauderdale Lakes, FL 33309-4240

Mailing address

3471 NW 43Rd PL
Lauderdale Lakes, FL 33309-4240
Phone (754) 971-1722

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
RBT-24-369124FLMDBehavior Technician

NPI Registry JSON

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

{
    "created_epoch": "1733356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733356800000",
    "number": "1700692696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3471 NW 43RD PL",
            "city": "LAUDERDALE LAKES",
            "state": "FL",
            "postal_code": "333094240",
            "telephone_number": "754-971-1722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3471 NW 43RD PL",
            "city": "LAUDERDALE LAKES",
            "state": "FL",
            "postal_code": "333094240",
            "telephone_number": "754-971-1722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COREUS",
        "first_name": "KIMORA",
        "middle_name": "CLAUDE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-12-05",
        "last_updated": "2024-12-05",
        "certification_date": "2024-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "FL",
            "license": "RBT-24-369124",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lauderdale Lakes, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2024; 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.