Individual provider Active NPI

Stephanie Pulido, PHARMD

  • Pharmacist
  • Miami Gardens, FL
National Provider Identifier
1033714712
Registry record updated Dec 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PS61876 Issued in FL
Practice address
4700 NW 183Rd St
Miami Gardens, FL 33055-2925
Phone
(305) 620-6055
NPI assigned
Dec 1, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PS61876 FL Primary

Addresses

Primary practice location

4700 NW 183Rd St
Miami Gardens, FL 33055-2925

Mailing address

4700 NW 183Rd St
Miami Gardens, FL 33055-2925
Phone (305) 620-6055

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

LicenseStateTypeSpecialty
PS61876FLMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Holiday CVS LLC CurrentSince Jun 22, 2021 Accepting new patients
Holiday CVS L.L.C. PastSince Dec 6, 2020 Accepting new patients

Locations

4700 NW 183rd St
Miami Gardens, FL 33055
Phone (305) 620-6055

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1606780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606780800000",
    "number": "1033714712",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4700 NW 183RD ST",
            "city": "MIAMI GARDENS",
            "state": "FL",
            "postal_code": "330552925",
            "telephone_number": "305-620-6055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4700 NW 183RD ST",
            "city": "MIAMI GARDENS",
            "state": "FL",
            "postal_code": "330552925",
            "telephone_number": "305-620-6055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PULIDO",
        "first_name": "STEPHANIE",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-12-01",
        "last_updated": "2020-12-01",
        "certification_date": "2020-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "FL",
            "license": "PS61876",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami Gardens, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.