Active NPI
Kristina Dimicco, RPH
- Pharmacist
- Vero Beach, FL
National Provider Identifier
1083951685
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PS43675
- Practice address
- 415 21St St
Vero Beach, FL 32960-5455 - Phone
- (772) 562-0541
- Fax
- (772) 562-0789
- NPI assigned
- Jan 16, 2013
- Sex
- Female
- 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 | PS43675 | FL | Primary |
Addresses
Primary practice location
415 21St St
Vero Beach, FL 32960-5455
Mailing address
415 21St St
Vero Beach, FL 32960-5455
Phone (772) 562-0541
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
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PS43675 | FL | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1358294400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1358294400000",
"number": "1083951685",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "415 21ST ST",
"city": "VERO BEACH",
"state": "FL",
"postal_code": "329605455",
"telephone_number": "772-562-0541",
"fax_number": "772-562-0789"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "415 21ST ST",
"city": "VERO BEACH",
"state": "FL",
"postal_code": "329605455",
"telephone_number": "772-562-0541",
"fax_number": "772-562-0789"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DIMICCO",
"first_name": "KRISTINA",
"name_prefix": "Dr.",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-01-16",
"last_updated": "2013-01-16",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "FL",
"license": "PS43675",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Vero Beach, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.