Jose Guillermo Cervantes Fernandez

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

1-20-42554 Issued in FL

Practice address

1930 NE 185TH Ter
North Miami Beach, FL 33179-4308

Phone

(786) 523-3249

NPI assigned

Jun 29, 2020

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Behavior Pedestal LLC

  • Behavior Analyst
  • North Miami Beach, FL
  • NPI 1447942537
  NPD

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

{
    "created_epoch": "1593388800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593388800000",
    "number": "1831716612",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1930 NE 185TH TER",
            "city": "NORTH MIAMI BEACH",
            "state": "FL",
            "postal_code": "331794308",
            "telephone_number": "786-523-3249"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1930 NE 185TH TER",
            "city": "NORTH MIAMI BEACH",
            "state": "FL",
            "postal_code": "331794308",
            "telephone_number": "786-523-3249"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CERVANTES FERNANDEZ",
        "first_name": "JOSE",
        "middle_name": "GUILLERMO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-06-29",
        "last_updated": "2020-06-29",
        "certification_date": "2020-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "FL",
            "license": "1-20-42554",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anabel Cento, ARNP
• Central Family Enrichment Network Inc
• Centrum Medical Centers of NMB, LLC
• Centrum Medical Centers of NMB, LLC
• Kery Cerne Constantin, LMHC
• Josyherli F Chacon
• Michelle Stephanie Chaltelt, MSW
• Massiel Chamorro, RBT
• Elaine Chan
• Gabriel Chang Torres

• Behavior Analyst in North Miami Beach, FL
• Providers in North Miami Beach, FL by specialty
• Behavior Analyst in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 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.

Verify at the official NPI Registry.