Peter Joseph Memoli

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

License

RBT-23-308841 Issued in FL

Practice address

3101 3Rd Ave N Unit 4606
Saint Petersburg, FL 33713-7668

Phone

(941) 704-5502

NPI assigned

May 23, 2021

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": "1621728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719273600000",
    "number": "1306411368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3151 3RD AVE N UNIT 3513",
            "city": "SAINT PETERSBURG",
            "state": "FL",
            "postal_code": "337137646",
            "telephone_number": "941-704-5502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3101 3RD AVE N UNIT 4606",
            "city": "SAINT PETERSBURG",
            "state": "FL",
            "postal_code": "337137668",
            "telephone_number": "941-704-5502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEMOLI",
        "first_name": "PETER",
        "middle_name": "JOSEPH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-05-23",
        "last_updated": "2024-06-25",
        "certification_date": "2024-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Behavior Technician",
            "state": "FL",
            "license": "605828",
            "primary": false
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Behavior Technician",
            "state": "FL",
            "license": "RBT-23-308841",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christine Mellace, D.O.
• Valentina Mellini
• Samantha Melo, MD
• Joni Krause Melville, ARNP
• Amanda Memken, PHARMD
• Gulnar Samreen Memon, PA
• Imtiaz Haroon Memon, PA
• Adialena Mena del Valle
• Nashlie Hegar Mena
• Mended Mind Therapy LLC

• Behavior Technician in Saint Petersburg, FL
• Providers in Saint Petersburg, FL by specialty
• Behavior Technician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2024; 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.