Dianisvey C Heredia Pais

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

License

20140340 Issued in FL

Practice address

6830 SW 132ND Ave
Miami, FL 33183-2382

Phone

(786) 878-0159

NPI assigned

Nov 29, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Dade Behavioral Services Inc

  • Behavior Analyst
  • Miami, FL
  • NPI 1063928562
  NPD (past)

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

{
    "created_epoch": "1638144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650931200000",
    "number": "1952069734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6830 SW 132ND AVE",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331832382",
            "telephone_number": "786-695-2240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6830 SW 132ND AVE",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331832382",
            "telephone_number": "786-878-0159"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEREDIA PAIS",
        "first_name": "DIANISVEY",
        "middle_name": "C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-11-29",
        "last_updated": "2022-04-26",
        "certification_date": "2022-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "FL",
            "license": "20140340",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "109080700",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "SOUTHKENDALLHOME@BELLSOUTH.NET",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "12448 SW 127th Ave",
            "city": "Miami",
            "state": "FL",
            "country_code": "US",
            "postal_code": "331866596",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Giselle Heredero
• Laura Heredia Gonzalez
• Susan Heredia Gonzalez
• Omar Alfonso Heredia Nieto, MD
• Wilson Domingo Heredia Nunez, M.D.
• Isabel Heredia, APRN
• Jimmy David Heredia, APN
• Mercedes Heredia
• Miguel A Heredia
• Yenisleidy Hereira

• Behavior Technician in Miami, FL
• Providers in Miami, FL by specialty
• Behavior Technician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 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.