Active NPI
Harry Russo
- Behavior Technician
- St Petersburg, FL
National Provider Identifier
1962063560
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- Practice address
- 8950 Martin Luther King St N Ste 190
St Petersburg, FL 33702-3001 - Phone
- (727) 576-7600
- NPI assigned
- Jun 25, 2019
- Sex
- Male
- 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 | Primary |
Addresses
Primary practice location
8950 Martin Luther King St N Ste 190
St Petersburg, FL 33702-3001
Mailing address
11329 Grandville Dr
Temple Terrace, FL 33617-2383
Phone (863) 559-7617
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1561420800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1561420800000",
"number": "1962063560",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11329 GRANDVILLE DR",
"city": "TEMPLE TERRACE",
"state": "FL",
"postal_code": "336172383",
"telephone_number": "863-559-7617"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8950 MARTIN LUTHER KING ST N STE 190",
"city": "ST PETERSBURG",
"state": "FL",
"postal_code": "337023001",
"telephone_number": "727-576-7600"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUSSO",
"first_name": "HARRY",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-06-25",
"last_updated": "2019-06-25",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in St Petersburg, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 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.