Individual provider Active NPI

Lissette Arango Ricardo

  • Behavior Technician
  • Hialeah, FL
National Provider Identifier
1770104770
Registry record updated Oct 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
License
20-116682 Issued in FL
Practice address
19630 W Lake Dr
Hialeah, FL 33015-2249
Phone
(786) 656-5167
NPI assigned
Apr 30, 2020
Last updated
Oct 19, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 19, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior TechnicianGroup: 193400000X SINGLE SPECIALTY GROUP 106S00000X 20-116682 FL Primary

Addresses

Primary practice location

19630 W Lake Dr
Hialeah, FL 33015-2249

Mailing address

19630 W Lake Dr
Hialeah, FL 33015-2249
Phone (786) 656-5167

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
20-116682FLMDBehavior Technician

NPI Registry JSON

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

{
    "created_epoch": "1588204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634601600000",
    "number": "1770104770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19630 W LAKE DR",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330152249",
            "telephone_number": "786-656-5167"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19630 W LAKE DR",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330152249",
            "telephone_number": "786-656-5167"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ARANGO RICARDO",
        "first_name": "LISSETTE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-04-30",
        "last_updated": "2021-10-19",
        "certification_date": "2021-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Behavior Technician",
            "state": "FL",
            "license": "20-116682",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hialeah, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 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.

Verify at the official NPI Registry.