{"npi":"1619497609","type":"NPI-2","status":"active","name":{"display":"Therapeutic Rebirth Corporation","other":[],"organization_name":"THERAPEUTIC REBIRTH CORPORATION","authorised_official":"Eduardo Alvarez"},"specialty":{"primary_taxonomy":"103K00000X","primary_taxonomy_description":"Behavior Analyst","slug":"behavior-analyst","schema_org_specialty":null,"all":[{"code":"261QD1600X","description":"Developmental Disabilities Clinic/Center","primary":false,"state":"FL","license":"MH7550"},{"code":"261QM0801X","description":"Mental Health Clinic/Center (Including Community Mental Health Center)","primary":false,"state":"FL","license":"MH7550"},{"code":"103K00000X","description":"Behavior Analyst","primary":true,"state":"FL","license":"MH7550"}]},"addresses":[{"purpose":"LOCATION","street_1":"4310 SW 164TH CT","city":"MIAMI","state":"FL","postal_code":"331855293","country_code":"US","phone":"3059050631"},{"purpose":"MAILING","street_1":"4310 SW 164TH CT","city":"MIAMI","state":"FL","postal_code":"331855293","country_code":"US","phone":"3059050631"}],"license":{"state":"FL","number":"MH7550"},"identifiers":[{"type_code":"05","label":"Medicaid","value":"017436200","state":"FL","issuer":null}],"pecos":{"enrolled_at":"2026-05-09T10:41:39.028268+00:00","enrollments":[{"enrlmt_id":"O20241114002447","type_code":"12-70","type_desc":"PART B SUPPLIER - CLINIC/GROUP PRACTICE","state":"FL","pac_id":"5890229769"}]},"enumeration_date":"2017-06-21","last_updated":"2022-07-21","_meta":{"source":"NPPES","snapshot_date":"2022-07-21","doc_url":"https://findmynpi.com/api"}}