Individual provider Active NPI

Raidel Alejandro Villafana Fernandez

  • Behavior Technician
  • Hialeah, FL
National Provider Identifier
1912781402
Registry record updated Aug 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
License
20-119903 Issued in FL
Practice address
6870 W 7TH Ave Apt 34B
Hialeah, FL 33014-4859
Phone
(786) 580-9883
NPI assigned
Aug 24, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 24, 2023

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 20-119903 FL Primary

Addresses

Primary practice location

6870 W 7TH Ave Apt 34B
Hialeah, FL 33014-4859

Mailing address

6870 W 7TH Ave Apt 34B
Hialeah, FL 33014-4859
Phone (786) 580-9883

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
20-119903FLMDBehavior Technician

NPI Registry JSON

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

{
    "created_epoch": "1692835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692835200000",
    "number": "1912781402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6870 W 7TH AVE APT 34B",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330144859",
            "telephone_number": "786-580-9883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6870 W 7TH AVE APT 34B",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330144859",
            "telephone_number": "786-580-9883"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VILLAFANA FERNANDEZ",
        "first_name": "RAIDEL",
        "middle_name": "ALEJANDRO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-08-24",
        "last_updated": "2023-08-24",
        "certification_date": "2023-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "FL",
            "license": "20-119903",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hialeah, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2023; 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.