Individual provider Active NPI

Marla Beatriz Rodriguez Gallardo

  • Behavior Analyst
  • Sunny Isles Beach, FL
National Provider Identifier
1730788225
Registry record updated Apr 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1-24-72729 Issued in FL
Practice address
300 Bayview Dr Apt 1803
Sunny Isles Beach, FL 33160-4747
Phone
(786) 499-6126
NPI assigned
Oct 26, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 30, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Assistant Behavior Analyst 106E00000X
Behavior TechnicianGroup: 193400000X SINGLE SPECIALTY GROUP 106S00000X
Behavior Analyst 103K00000X 1-24-72729 FL Primary

Addresses

Primary practice location

300 Bayview Dr Apt 1803
Sunny Isles Beach, FL 33160-4747

Mailing address

300 Bayview Dr Apt 1803
Sunny Isles Beach, FL 33160-4747
Phone (786) 499-6126

Other identifiers 1

IdentifierTypeStateIssuer
107674000MedicaidFL

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

NPI Registry JSON

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

{
    "created_epoch": "1603670400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714435200000",
    "number": "1730788225",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 BAYVIEW DR APT 1803",
            "city": "SUNNY ISLES BEACH",
            "state": "FL",
            "postal_code": "331604747",
            "telephone_number": "786-499-6126"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 BAYVIEW DR APT 1803",
            "city": "SUNNY ISLES BEACH",
            "state": "FL",
            "postal_code": "331604747",
            "telephone_number": "786-499-6126"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ GALLARDO",
        "first_name": "MARLA",
        "middle_name": "BEATRIZ",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-10-26",
        "last_updated": "2024-04-30",
        "certification_date": "2024-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106E00000X",
            "taxonomy_group": "",
            "desc": "Assistant Behavior Analyst",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "FL",
            "license": "1-24-72729",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "107674000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sunny Isles Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 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.