Active NPI
Aisha Gomango
- Pharmacist
- Estero, FL
National Provider Identifier
1063930923
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PS56695
- Practice address
- 21301 S Tamiami TRL
Estero, FL 33928-2942 - Phone
- (239) 948-1182
- NPI assigned
- Aug 31, 2017
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | PS56695 | FL | Primary |
Addresses
Primary practice location
21301 S Tamiami TRL
Estero, FL 33928-2942
Mailing address
21301 S Tamiami TRL
Estero, FL 33928-2942
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 |
|---|---|---|---|
| PS56695 | FL | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Publix Super Markets Inc | Past | Accepting new patients |
Organizations & group practices 1
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
- Winter Haven, FL
- NPI 1760356380
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1504137600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1504137600000",
"number": "1063930923",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "21301 S TAMIAMI TRL",
"city": "ESTERO",
"state": "FL",
"postal_code": "339282942"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "21301 S TAMIAMI TRL",
"city": "ESTERO",
"state": "FL",
"postal_code": "339282942",
"telephone_number": "239-948-1182"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOMANGO",
"first_name": "AISHA",
"name_prefix": "Dr.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-08-31",
"last_updated": "2017-08-31",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "FL",
"license": "PS56695",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Estero, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.