Active NPI
Dory Ailec Abellon Mederos
- Behavior Technician
- Miami Garden, FL
National Provider Identifier
1912475898
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- Practice address
- 3270 NW 208 St
Miami Garden, FL 33056 - Phone
- (786) 757-3275
- NPI assigned
- Nov 8, 2018
- Sex
- Female
- 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 | FL | Primary |
Addresses
Primary practice location
3270 NW 208 St
Miami Garden, FL 33056
Mailing address
3270 NW 208 St
Miami Garden, FL 33056
Phone (786) 757-3275
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 019761100 | 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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Peace of Mind Mental Health Services Corp | Single Specialty | 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 and National Provider Directory roles.
-
- Behavior Analyst
- Miami Lakes, FL
- NPI 1659803773
Single Specialty
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1541635200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1541635200000",
"number": "1912475898",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3270 NW 208 ST",
"city": "MIAMI GARDEN",
"state": "FL",
"postal_code": "33056",
"telephone_number": "786-757-3275"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3270 NW 208 ST",
"city": "MIAMI GARDEN",
"state": "FL",
"postal_code": "33056",
"telephone_number": "786-757-3275"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ABELLON MEDEROS",
"first_name": "DORY",
"middle_name": "AILEC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-11-08",
"last_updated": "2018-11-08",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Behavior Technician",
"state": "FL",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "019761100",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Miami Garden, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.