Active NPI
Eduardo Jose Maldonado
- Behavior Technician
- Woodbridge, VA
National Provider Identifier
1710655915
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- RBT-17-32126
- Practice address
- 13835 Gullane Dr
Woodbridge, VA 22191-1461 - Phone
- (703) 678-9497
- NPI assigned
- Sep 1, 2021
- Last updated
- Sep 1, 2021
- 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 | RBT-17-32126 | FL | Primary |
Addresses
Primary practice location
13835 Gullane Dr
Woodbridge, VA 22191-1461
Mailing address
910 N Iverson St Apt 302
Alexandria, VA 22304-6835
Phone (954) 793-3305
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-17-32126 | FL | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1630454400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1630454400000",
"number": "1710655915",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "910 N IVERSON ST APT 302",
"city": "ALEXANDRIA",
"state": "VA",
"postal_code": "223046835",
"telephone_number": "954-793-3305"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13835 GULLANE DR",
"city": "WOODBRIDGE",
"state": "VA",
"postal_code": "221911461",
"telephone_number": "703-678-9497"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MALDONADO",
"first_name": "EDUARDO",
"middle_name": "JOSE",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-09-01",
"last_updated": "2021-09-01",
"certification_date": "2021-09-01",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "FL",
"license": "RBT-17-32126",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Woodbridge, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.