Active NPI
Carly Acquaviva, PHARM. D
- Pharmacist
- Palm Bay, FL
National Provider Identifier
1003211947
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PS51839
- Practice address
- 1555 Port Malabar Blvd NE
Suite 101
Palm Bay, FL 32905-5407 - Phone
- (321) 725-7188
- NPI assigned
- Nov 4, 2014
- 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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | PS51839 | FL | Primary |
Addresses
Primary practice location
1555 Port Malabar Blvd NE
Suite 101
Palm Bay, FL 32905-5407
Mailing address
1555 Port Malabar Blvd NE
Suite 101
Palm Bay, FL 32905-5407
Phone (321) 725-7188
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
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PS51839 | FL | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Carl D Acquaviva | Past | Accepting new patients | |
| Carl D Acquaviva | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Community/Retail Pharmacy
- Palm Bay, FL
- NPI 1013928514
-
- Community/Retail Pharmacy
- Palm Bay, FL
- NPI 1528203775
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1415059200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1415059200000",
"number": "1003211947",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1555 PORT MALABAR BLVD NE",
"address_2": "SUITE 101",
"city": "PALM BAY",
"state": "FL",
"postal_code": "329055407",
"telephone_number": "321-725-7188"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1555 PORT MALABAR BLVD NE",
"address_2": "SUITE 101",
"city": "PALM BAY",
"state": "FL",
"postal_code": "329055407",
"telephone_number": "321-725-7188"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ACQUAVIVA",
"first_name": "CARLY",
"credential": "PHARM. D",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-11-04",
"last_updated": "2014-11-04",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "FL",
"license": "PS51839",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Palm Bay, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.