What is Keanu Boullon's NPI number?

Keanu Boullon's National Provider Identifier (NPI) is 1144105982, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.

What is Keanu Boullon's specialty?

Keanu Boullon is listed in the NPPES registry with a primary specialty of Behavior Technician (Behavioral Health & Social Service Providers).

Where is Keanu Boullon located?

Keanu Boullon's practice location on file with NPPES is 12505 Sw 28th St, Miami, FL 33175-2112.

What is Keanu Boullon's phone number?

The practice phone number listed in the NPPES registry for Keanu Boullon is (786) 770-5813.

Is Keanu Boullon's NPI active?

Yes — Keanu Boullon's NPI (1144105982) is active in the NPPES registry as of the last update on 2025-08-11.

IndividualActive

Keanu Boullon

NPI 1144105982 · Behavior Technician · Miami, FL

Keanu Boullon is a Behavior Technician provider in Miami, FL (NPI 1144105982).

Provider details

NPI number: 1144105982
Entity type: Individual
Primary specialty: Behavior TechnicianBehavioral Health & Social Service Providers
Sex: Male
Sole proprietor: Yes
License: BACB1331319 (FL)

Specialties & taxonomies

Behavior TechnicianPrimary106S00000XLicense BACB1331319 (FL)
Behavioral Health & Social Service Providers

Profile Score

Established profile(54/100 index)

A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.

Registry tenure38% of score
Under 1 yr in registry
Profile completeness38% of score
100% of core fields populated
Practice footprint23% of score
1 documented practice location

Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.

Practice location

12505 Sw 28th St

Miami, FL 33175-2112

Phone: (786) 770-5813

Street-level locationGet directions

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Mailing address