Individual provider Active NPI

Diliam Mosqueda Lopez

  • Behavior Technician
  • Miami Gardens, FL
National Provider Identifier
1790509669
Registry record updated Feb 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
License
RBT-24-392067 Issued in FL
Practice address
18902 NW 48TH Ave
Miami Gardens, FL 33055-2532
Phone
(305) 753-3908
NPI assigned
Nov 8, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 10, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X RBT-24-392067 FL Primary

Addresses

Primary practice location

18902 NW 48TH Ave
Miami Gardens, FL 33055-2532

Mailing address

18902 NW 48TH Ave
Miami Gardens, FL 33055-2532
Phone (305) 753-3908

Other identifiers 1

IdentifierTypeStateIssuer
125071300MedicaidFL

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
RBT-24-392067FLMDBehavior Technician

NPI Registry JSON

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

{
    "created_epoch": "1731024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739145600000",
    "number": "1790509669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18902 NW 48TH AVE",
            "city": "MIAMI GARDENS",
            "state": "FL",
            "postal_code": "330552532",
            "telephone_number": "305-753-3908"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18902 NW 48TH AVE",
            "city": "MIAMI GARDENS",
            "state": "FL",
            "postal_code": "330552532",
            "telephone_number": "305-753-3908"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOSQUEDA LOPEZ",
        "first_name": "DILIAM",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-11-08",
        "last_updated": "2025-02-10",
        "certification_date": "2025-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "FL",
            "license": "RBT-24-392067",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "125071300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami Gardens, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2025; 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.