Nicole Grullon, RBT

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

License

RBT-17-46606 Issued in FL

Practice address

11441 Interchange Cir S
Miramar, FL 33025-6009

Phone

(305) 573-6333

NPI assigned

Feb 21, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1519171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1519171200000",
    "number": "1730680109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13000 SW 15TH CT APT 309U",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330272405",
            "telephone_number": "305-213-1003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11441 INTERCHANGE CIR S",
            "city": "MIRAMAR",
            "state": "FL",
            "postal_code": "330256009",
            "telephone_number": "305-573-6333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRULLON",
        "first_name": "NICOLE",
        "credential": "RBT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-02-21",
        "last_updated": "2018-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "FL",
            "license": "RBT-17-46606",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Behavior Technician in Miramar, FL
• Providers in Miramar, FL by specialty
• Behavior Technician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 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.