Active NPI
Anthony Pavone
- Behavior Analyst
- Brandon, FL
National Provider Identifier
1275939571
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 11410191
- Practice address
- 912 Milano Cir Apt 107
Brandon, FL 33511-7150 - Phone
- (773) 517-0367
- NPI assigned
- Nov 13, 2014
- Sex
- Male
- Sole proprietor
- Yes
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 Analyst | 103K00000X | 11410191 | IL | Primary |
Addresses
Primary practice location
912 Milano Cir Apt 107
Brandon, FL 33511-7150
Mailing address
5 Revere Dr Ste 12
Northbrook, IL 60062-1566
Phone (847) 807-3717
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 |
|---|---|---|---|
| 11410191 | IL | MD | Behavioral Analyst |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1415836800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1564358400000",
"number": "1275939571",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5 REVERE DR STE 12",
"city": "NORTHBROOK",
"state": "IL",
"postal_code": "600621566",
"telephone_number": "847-807-3717"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "912 MILANO CIR APT 107",
"city": "BRANDON",
"state": "FL",
"postal_code": "335117150",
"telephone_number": "773-517-0367"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PAVONE",
"first_name": "ANTHONY",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2014-11-13",
"last_updated": "2019-07-29",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "IL",
"license": "11410191",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brandon, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.