Active NPI
Yenny Coromoto Marquez de Guethon
- Behavior Technician
- Pompano Beach, FL
National Provider Identifier
1962080366
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- RBT-19-108464
- Practice address
- 4050 NE 12TH Ave
Pompano Beach, FL 33064-6109 - Phone
- (954) 548-7283
- NPI assigned
- Mar 30, 2021
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Case Manager/Care Coordinator | 171M00000X | |||
| Behavior Technician | 106S00000X | RBT-19-108464 | FL | Primary |
Addresses
Primary practice location
4050 NE 12TH Ave
Pompano Beach, FL 33064-6109
Mailing address
4050 NE 12TH Ave
Pompano Beach, FL 33064-6109
Phone (954) 548-7283
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 105649500 | 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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RBT-19-108464 | FL | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1617062400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1632700800000",
"number": "1962080366",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4050 NE 12TH AVE",
"city": "POMPANO BEACH",
"state": "FL",
"postal_code": "330646109",
"telephone_number": "954-548-7283"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4050 NE 12TH AVE",
"city": "POMPANO BEACH",
"state": "FL",
"postal_code": "330646109",
"telephone_number": "954-548-7283"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARQUEZ DE GUETHON",
"first_name": "YENNY",
"middle_name": "COROMOTO",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-03-30",
"last_updated": "2021-09-27",
"certification_date": "2021-09-27",
"status": "A"
},
"taxonomies": [
{
"code": "171M00000X",
"taxonomy_group": "",
"desc": "Case Manager/Care Coordinator",
"state": null,
"license": null,
"primary": false
},
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "FL",
"license": "RBT-19-108464",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "105649500",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Pompano Beach, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 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.