Active NPI
Raydel Encarnacion
- Behavior Technician
- Homestead, FL
National Provider Identifier
1952673998
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- RBT-20-128546
- Practice address
- 25621 SW 133Rd CT
Homestead, FL 33032-6846 - Phone
- (305) 219-1620
- NPI assigned
- Feb 7, 2012
- Reactivated
- Aug 20, 2021
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | MA67026 | FL | |
| Behavior Technician | 106S00000X | RBT-20-128546 | FL | Primary |
Addresses
Primary practice location
25621 SW 133Rd CT
Homestead, FL 33032-6846
Mailing address
25621 SW 133Rd CT
Homestead, FL 33032-6846
Phone (305) 219-1620
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
| License | State | Type | Specialty |
|---|---|---|---|
| RBT-20-128546 | FL | MD | Behavior Technician |
| MA67026 | FL | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1328572800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1630022400000",
"number": "1952673998",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "25621 SW 133RD CT",
"city": "HOMESTEAD",
"state": "FL",
"postal_code": "330326846",
"telephone_number": "305-219-1620"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "25621 SW 133RD CT",
"city": "HOMESTEAD",
"state": "FL",
"postal_code": "330326846",
"telephone_number": "305-219-1620"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ENCARNACION",
"first_name": "RAYDEL",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2012-02-07",
"last_updated": "2021-08-27",
"certification_date": "2021-08-27",
"deactivation_date": "2021-08-10",
"reactivation_date": "2021-08-20",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "FL",
"license": "MA67026",
"primary": false
},
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "FL",
"license": "RBT-20-128546",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Homestead, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.