Active NPI
Itzel Pallares
- Behavior Analyst
- St. Petersburg, FL
National Provider Identifier
1982291969
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 1-25-80026
- Practice address
- 10901 Roosevelt Blvd
Ste 100
St. Petersburg, FL 33716-2305 - Phone
- (888) 754-0398
- NPI assigned
- Dec 24, 2020
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | 20148956 | FL | |
| Behavior Analyst | 103K00000X | 1-25-80026 | FL | Primary |
Addresses
Primary practice location
10901 Roosevelt Blvd
Ste 100
St. Petersburg, FL 33716-2305
Mailing address
10901 Roosevelt Blvd
Ste 100
St. Petersburg, FL 33716-2305
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 |
|---|---|---|---|
| 20148956 | FL | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1608768000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1743984000000",
"number": "1982291969",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10901 ROOSEVELT BLVD",
"address_2": "STE 100",
"city": "ST. PETERSBURG",
"state": "FL",
"postal_code": "337162305"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10901 ROOSEVELT BLVD",
"address_2": "STE 100",
"city": "ST. PETERSBURG",
"state": "FL",
"postal_code": "337162305",
"telephone_number": "888-754-0398"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PALLARES",
"first_name": "ITZEL",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-12-24",
"last_updated": "2025-04-07",
"certification_date": "2025-04-07",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "FL",
"license": "20148956",
"primary": false
},
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "FL",
"license": "1-25-80026",
"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 Apr 7, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.