Active NPI
Shande Emilio Perez, RBT
- Behavior Technician
- Homestead, FL
National Provider Identifier
1780404855
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- 24-367094
- Practice address
- 11872 SW 272ND Ter
Homestead, FL 33032-3388 - Phone
- (786) 886-9307
- NPI assigned
- Oct 14, 2024
- Last updated
- Oct 14, 2024
- Sex
- Male
- Sole proprietor
- Yes
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 | 24-367094 | FL | Primary |
Addresses
Primary practice location
11872 SW 272ND Ter
Homestead, FL 33032-3388
Mailing address
11872 SW 272ND Ter
Homestead, FL 33032-3388
Phone (786) 886-9307
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 |
|---|---|---|---|
| 24-367094 | FL | MD | Behavior Technician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sunny Behavior LLC | Single Specialty | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1728864000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1728864000000",
"number": "1780404855",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11872 SW 272ND TER",
"city": "HOMESTEAD",
"state": "FL",
"postal_code": "330323388",
"telephone_number": "786-886-9307"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11872 SW 272ND TER",
"city": "HOMESTEAD",
"state": "FL",
"postal_code": "330323388",
"telephone_number": "786-886-9307"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PEREZ",
"first_name": "SHANDE",
"middle_name": "EMILIO",
"credential": "RBT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2024-10-14",
"last_updated": "2024-10-14",
"certification_date": "2024-10-14",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "FL",
"license": "24-367094",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Homestead, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 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.