Individual provider Active NPI

Allison Katheryn Blanco

  • Behavior Analyst
  • Stuart, FL
National Provider Identifier
1124667761
Registry record updated Jun 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
12258543 Issued in FL
Practice address
7108 South Kanner Hwy
Stuart, FL 34997
Phone
(855) 832-6727
NPI assigned
Dec 30, 2019
Reactivated
Feb 20, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X 12258543 FL Primary

Addresses

Primary practice location

7108 South Kanner Hwy
Stuart, FL 34997

Mailing address

9756 Glen Heron Dr
Bonita Springs, FL 34135-7773
Phone (239) 963-6002

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

LicenseStateTypeSpecialty
12258543FLMDBehavioral Analyst

NPI Registry JSON

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

{
    "created_epoch": "1577664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780963200000",
    "number": "1124667761",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9756 GLEN HERON DR",
            "city": "BONITA SPRINGS",
            "state": "FL",
            "postal_code": "341357773",
            "telephone_number": "239-963-6002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7108 SOUTH KANNER HWY",
            "city": "STUART",
            "state": "FL",
            "postal_code": "34997",
            "telephone_number": "855-832-6727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLANCO",
        "first_name": "ALLISON",
        "middle_name": "KATHERYN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-12-30",
        "last_updated": "2026-06-09",
        "certification_date": "2026-06-09",
        "deactivation_date": "2024-01-30",
        "reactivation_date": "2024-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "FL",
            "license": "12258543",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stuart, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2026; 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.