Individual provider Active NPI

Tricia A Gangoo, PHARMD

  • Pharmacist
  • Ft Lauderdale, FL
National Provider Identifier
1043352511
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PS29380 Issued in FL
Practice address
3116 W Commercial Blvd
Ft Lauderdale, FL 33309-3415
Phone
(954) 739-2829
Fax
(954) 739-3680
NPI assigned
Feb 13, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PS29380 FL Primary

Addresses

Primary practice location

3116 W Commercial Blvd
Ft Lauderdale, FL 33309-3415

Mailing address

6950 NW 28TH St
Margate, FL 33063-2051
Phone (954) 593-4038

Other identifiers 1

IdentifierTypeStateIssuer
PS29380OtherFLSTATE LICENSE #

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
PS29380FLMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1171324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1043352511",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6950 NW 28TH ST",
            "city": "MARGATE",
            "state": "FL",
            "postal_code": "330632051",
            "telephone_number": "954-593-4038",
            "fax_number": "954-739-3680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3116 W COMMERCIAL BLVD",
            "city": "FT LAUDERDALE",
            "state": "FL",
            "postal_code": "333093415",
            "telephone_number": "954-739-2829",
            "fax_number": "954-739-3680"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GANGOO",
        "first_name": "TRICIA",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "FL",
            "license": "PS29380",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE #",
            "identifier": "PS29380",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ft Lauderdale, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.