Shane Tarkir

Primary specialty

Assistant Behavior AnalystTaxonomy code 106E00000X

License

0-25-16010 Issued in FL

Practice address

5959 Lake Ellenor Dr
Orlando, FL 32809-4633

Phone

(321) 972-4039

NPI assigned

Nov 14, 2022

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1668384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744502400000",
    "number": "1093423584",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1154 SW 25TH AVE",
            "city": "BOYNTON BEACH",
            "state": "FL",
            "postal_code": "334267444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5959 LAKE ELLENOR DR",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328094633",
            "telephone_number": "321-972-4039"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TARKIR",
        "first_name": "SHANE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-11-14",
        "last_updated": "2025-04-13",
        "certification_date": "2025-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "FL",
            "license": "RBT-22-243636",
            "primary": false
        },
        {
            "code": "106E00000X",
            "taxonomy_group": "",
            "desc": "Assistant Behavior Analyst",
            "state": "FL",
            "license": "0-25-16010",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Target Corporation and Subsidiaries (Target Pharmacy)
• Elizabeth Tarife Segura
• Brittany A Tarin, PTA
• Eeman Tariq, MD
• Nimra Tariq
• Amanda Frances Tarkowski, M.D.
• Ivan Tarle, MD
• Kimberly Varner Tarman
• Sean Tarride, D.O
• Koorosh Tartibi

• Assistant Behavior Analyst in Orlando, FL
• Providers in Orlando, FL by specialty
• Assistant Behavior Analyst in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2025; 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.