NPIMap

Organization Active NPI

Neurodverse LLC

  • Behavior Analyst
  • Doral, FL
National Provider Identifier
1912615873
Registry record updated Nov 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Legal business name
NEURODVERSE LLC
Practice address
10820 NW 85TH Ter
Doral, FL 33178-1545
Phone
(786) 384-1063
NPI assigned
Nov 9, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2022

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

Authorized official

Name
Mrs. Gretel Debasa MarimonNPI 1881056539
Title
Bcba
Phone
(786) 384-1063

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior AnalystGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 103K00000X Primary

Addresses

Primary practice location

10820 NW 85TH Ter
Doral, FL 33178-1545

Mailing address

10820 NW 85TH Ter
Doral, FL 33178-1545
Phone (786) 384-1063

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1667952000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1667952000000",
    "number": "1912615873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10820 NW 85TH TER",
            "city": "DORAL",
            "state": "FL",
            "postal_code": "331781545",
            "telephone_number": "786-384-1063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10820 NW 85TH TER",
            "city": "DORAL",
            "state": "FL",
            "postal_code": "331781545",
            "telephone_number": "786-384-1063"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEURODVERSE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-11-09",
        "last_updated": "2022-11-09",
        "certification_date": "2022-11-09",
        "status": "A",
        "authorized_official_last_name": "DEBASA MARIMON",
        "authorized_official_first_name": "GRETEL",
        "authorized_official_title_or_position": "BCBA",
        "authorized_official_telephone_number": "786-384-1063",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Doral, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2022; 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.