Active NPI
Rafael Mugia Fernandez
- Behavior Technician
- Hialeah, FL
National Provider Identifier
1790277382
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- 19-88904
- Practice address
- 695 E 8TH CT
Hialeah, FL 33010 - Phone
- (716) 868-8387
- NPI assigned
- May 31, 2018
- Last updated
- Jan 27, 2020
- 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 | 19-88904 | FL | Primary |
Addresses
Primary practice location
695 E 8TH CT
Hialeah, FL 33010
Mailing address
695 E 8TH CT
Hialeah, FL 33010-4619
Phone (716) 868-8387
Other practice location 1
3829 Hollywood Blvd Ste D
Hollywood, FL 33021-6790
Phone (954) 367-3600
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 23346900 | Medicaid | FL |
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 |
|---|---|---|---|
| 19-88904 | FL | MD | Behavior Technician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Family Enrichment Behavioral Health Services Inc | Behavior Technician | 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.
-
dba Family Enrichment Behavior
- Community/Behavioral Health Agency
- Hollywood, FL
- NPI 1821240185
Behavior Technician
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1527724800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1580083200000",
"number": "1790277382",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "695 E 8TH CT",
"city": "HIALEAH",
"state": "FL",
"postal_code": "330104619",
"telephone_number": "716-868-8387"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "695 E 8TH CT",
"city": "HIALEAH",
"state": "FL",
"postal_code": "33010",
"telephone_number": "716-868-8387"
}
],
"practiceLocations": [
{
"address_1": "3829 Hollywood Blvd Ste D",
"address_purpose": "LOCATION",
"city": "Hollywood",
"state": "FL",
"postal_code": "330216790",
"country_code": "US",
"telephone_number": "954-367-3600",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MUGIA FERNANDEZ",
"first_name": "RAFAEL",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2018-05-31",
"last_updated": "2020-01-27",
"certification_date": "2020-01-27",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "FL",
"license": "19-88904",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "23346900",
"state": "FL"
}
],
"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 Jan 27, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.