Individual provider Active NPI

Addel Manuel Jurado Jomarron

  • Behavior Technician
  • Boca Raton, FL
National Provider Identifier
1881439990
Registry record updated Jun 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
License
RBT-24-356611 Issued in FL
Practice address
22218 SW 58TH Ave
Boca Raton, FL 33428-4532
Phone
(561) 212-9288
NPI assigned
Jun 28, 2024
Last updated
Jun 28, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2024

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-24-356611 FL Primary

Addresses

Primary practice location

22218 SW 58TH Ave
Boca Raton, FL 33428-4532

Mailing address

22218 SW 58TH Ave
Boca Raton, FL 33428-4532
Phone (561) 212-9288

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-24-356611FLMDBehavior Technician

NPI Registry JSON

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

{
    "created_epoch": "1719532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719532800000",
    "number": "1881439990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22218 SW 58TH AVE",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334284532",
            "telephone_number": "561-212-9288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22218 SW 58TH AVE",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334284532",
            "telephone_number": "561-212-9288"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JURADO JOMARRON",
        "first_name": "ADDEL",
        "middle_name": "MANUEL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-06-28",
        "last_updated": "2024-06-28",
        "certification_date": "2024-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "FL",
            "license": "RBT-24-356611",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boca Raton, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 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.

Verify at the official NPI Registry.