Active NPI
Jennifer Prado Rodriguez
- Behavior Technician
- Miami Gardens, FL
National Provider Identifier
1972104586
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- P636424019230
- Practice address
- 3360 NW 171St Ter
Miami Gardens, FL 33056-4259 - Phone
- (786) 470-4454
- NPI assigned
- Nov 2, 2020
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | P636424019230 | FL | Primary |
Addresses
Primary practice location
3360 NW 171St Ter
Miami Gardens, FL 33056-4259
Mailing address
3360 NW 171St Ter
Miami Gardens, FL 33056-4259
Phone (786) 470-4454
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 |
|---|---|---|---|
| P636424019230 | FL | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1604275200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1604275200000",
"number": "1972104586",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3360 NW 171ST TER",
"city": "MIAMI GARDENS",
"state": "FL",
"postal_code": "330564259",
"telephone_number": "786-470-4454"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3360 NW 171ST TER",
"city": "MIAMI GARDENS",
"state": "FL",
"postal_code": "330564259",
"telephone_number": "786-470-4454"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PRADO RODRIGUEZ",
"first_name": "JENNIFER",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-11-02",
"last_updated": "2020-11-02",
"certification_date": "2020-11-02",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "FL",
"license": "P636424019230",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Miami Gardens, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.