Individual provider Active NPI

Yamila Matanza

  • Behavior Technician
  • Hialeah, FL
National Provider Identifier
1962162495
Registry record updated Dec 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
License
RBT-20-145544 Issued in FL
Practice address
975 E 4TH St
Hialeah, FL 33010-5111
Phone
(786) 290-1380
NPI assigned
Dec 24, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 24, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior TechnicianGroup: 193400000X SINGLE SPECIALTY GROUP 106S00000X RBT-20-145544 FL Primary

Addresses

Primary practice location

975 E 4TH St
Hialeah, FL 33010-5111

Mailing address

975 E 4TH St
Hialeah, FL 33010-5111
Phone (786) 290-1380

Other identifiers 1

IdentifierTypeStateIssuer
0000000000OtherFLNONE

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL EMAIL Direct

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
RBT-20-145544FLMDBehavior Technician

NPI Registry JSON

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

{
    "created_epoch": "1640304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640304000000",
    "number": "1962162495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "975 E 4TH ST",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330105111",
            "telephone_number": "786-290-1380"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "975 E 4TH ST",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330105111",
            "telephone_number": "786-290-1380"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATANZA",
        "first_name": "YAMILA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-12-24",
        "last_updated": "2021-12-24",
        "certification_date": "2021-12-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Behavior Technician",
            "state": "FL",
            "license": "RBT-20-145544",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NONE",
            "identifier": "0000000000",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "EMAIL",
            "affiliation": "N",
            "endpointDescription": "EMAIL",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "975 E 4th St",
            "city": "Hialeah",
            "state": "FL",
            "country_code": "US",
            "postal_code": "330105111",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "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 Dec 24, 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.

Verify at the official NPI Registry.