Active NPI
Iris Nisanov
- Behavior Technician
- Boca Raton, FL
National Provider Identifier
1780317909
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- RBT-22-221435
- Practice address
- 7707 Courtyard Run W
Boca Raton, FL 33433-3035 - Phone
- (347) 863-5739
- NPI assigned
- Jul 5, 2022
- Last updated
- Sep 29, 2026
- Sex
- Female
- Sole proprietor
- No
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 Technician | 106S00000X | RBT-22-221435 | FL | Primary |
Addresses
Primary practice location
7707 Courtyard Run W
Boca Raton, FL 33433-3035
Mailing address
5840 Lakeshore Dr Apt 216
Fort Lauderdale, FL 33312-6454
Phone (347) 863-5739
Other practice location 1
5840 Lakeshore Dr
Fort Lauderdale, FL 33312-6404
Phone (347) 863-5739
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 |
|---|---|---|---|
| RBT-22-221435 | FL | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1656979200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1790640000000",
"number": "1780317909",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5840 LAKESHORE DR APT 216",
"city": "FORT LAUDERDALE",
"state": "FL",
"postal_code": "333126454",
"telephone_number": "347-863-5739"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7707 COURTYARD RUN W",
"city": "BOCA RATON",
"state": "FL",
"postal_code": "334333035",
"telephone_number": "347-863-5739"
}
],
"practiceLocations": [
{
"address_1": "5840 Lakeshore Dr",
"address_purpose": "LOCATION",
"city": "Fort Lauderdale",
"state": "FL",
"postal_code": "333126404",
"country_code": "US",
"telephone_number": "347-863-5739",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "NISANOV",
"first_name": "IRIS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-07-05",
"last_updated": "2026-09-29",
"certification_date": "2022-07-05",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "FL",
"license": "RBT-22-221435",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Boca Raton, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 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.