Individual provider Active NPI

Shannell B Rodriguez-Vila

  • Behavior Technician
  • Miami, FL
National Provider Identifier
1801476577
Registry record updated Dec 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
License
RBT-21-155822 Issued in FL
Practice address
1045 SW 147TH Ave
Miami, FL 33194-2947
Phone
(786) 355-4202
NPI assigned
Apr 8, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 13, 2021

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-21-155822 FL Primary

Addresses

Primary practice location

1045 SW 147TH Ave
Miami, FL 33194-2947

Mailing address

1045 SW 147TH Ave
Miami, FL 33194-2947

Other practice location 1

6405 NW 36th St Ste 100
Virginia Gardens, FL 33166-6977
Phone (786) 953-8500

Other identifiers 1

IdentifierTypeStateIssuer
110132900MedicaidFL

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-21-155822FLMDBehavior Technician

NPI Registry JSON

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

{
    "created_epoch": "1617840000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639353600000",
    "number": "1801476577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1045 SW 147TH AVE",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331942947"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1045 SW 147TH AVE",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331942947",
            "telephone_number": "786-355-4202"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6405 NW 36th St Ste 100",
            "address_purpose": "LOCATION",
            "city": "Virginia Gardens",
            "state": "FL",
            "postal_code": "331666977",
            "country_code": "US",
            "telephone_number": "786-953-8500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RODRIGUEZ-VILA",
        "first_name": "SHANNELL",
        "middle_name": "B",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-04-08",
        "last_updated": "2021-12-13",
        "certification_date": "2021-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "FL",
            "license": "RBT-21-155822",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110132900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 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.