Individual provider Active NPI

Edda Marin Mendoza

  • Behavior Technician
  • Hialeah, FL
National Provider Identifier
1962931790
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
Practice address
1885 W 56TH St Apt 406
Hialeah, FL 33012-7361
Phone
(786) 372-4892
NPI assigned
Jun 6, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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 Primary

Addresses

Primary practice location

1885 W 56TH St Apt 406
Hialeah, FL 33012-7361

Mailing address

1885 W 56TH St Apt 406
Hialeah, FL 33012-7361
Phone (786) 372-4892

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

NPI Registry JSON

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

{
    "created_epoch": "1496707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1962931790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1885 W 56TH ST APT 406",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330127361",
            "telephone_number": "786-372-4892"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1885 W 56TH ST APT 406",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330127361",
            "telephone_number": "786-372-4892"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARIN MENDOZA",
        "first_name": "EDDA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-06-06",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "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 Jul 21, 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.