Active NPI
Michael David
- Pharmacist
- Jacksonville, FL
National Provider Identifier
1033493077
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PS36011
- Practice address
- 1220 University Blvd N
Jacksonville, FL 32211-8852 - Phone
- (904) 762-6892
- Fax
- (904) 762-6897
- NPI assigned
- Oct 10, 2011
- Last updated
- Oct 10, 2011
- 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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | PS36011 | FL | Primary |
Addresses
Primary practice location
1220 University Blvd N
Jacksonville, FL 32211-8852
Mailing address
12211 Woodbend CT
Jacksonville, FL 32246-4221
Phone (904) 998-8333
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 |
|---|---|---|---|
| PS36011 | FL | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1318204800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1318204800000",
"number": "1033493077",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12211 WOODBEND CT",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322464221",
"telephone_number": "904-998-8333"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1220 UNIVERSITY BLVD N",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322118852",
"telephone_number": "904-762-6892",
"fax_number": "904-762-6897"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVID",
"first_name": "MICHAEL",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-10-10",
"last_updated": "2011-10-10",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "FL",
"license": "PS36011",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jacksonville, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.