Individual provider Active NPI

Jimmy Stephano Dumornay

  • Pharmacist
  • Tampa, FL
National Provider Identifier
1083764898
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PS39154 Issued in FL
Practice address
1117 Andrew Aviles Cir
Tampa, FL 33619-5007
Phone
(781) 775-7182
NPI assigned
Jan 12, 2007
Sex
Male
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 PS39154 FL Primary

Addresses

Primary practice location

1117 Andrew Aviles Cir
Tampa, FL 33619-5007

Mailing address

1117 Andrew Aviles Cir
Tampa, FL 33619-5007
Phone (813) 476-7724

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

LicenseStateTypeSpecialty
PS39154FLMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1168560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1083764898",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1117 ANDREW AVILES CIR",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336195007",
            "telephone_number": "813-476-7724"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1117 ANDREW AVILES CIR",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336195007",
            "telephone_number": "781-775-7182"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUMORNAY",
        "first_name": "JIMMY",
        "middle_name": "STEPHANO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "FL",
            "license": "PS39154",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, 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.