Individual provider Active NPI

Imuentinyan Sariratu Salami

  • Pharmacist
  • Miami, FL
National Provider Identifier
1093301707
Registry record updated Dec 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PS33069 Issued in FL
Practice address
3135 Grand Ave
Miami, FL 33133-5103
Phone
(305) 445-7533
Fax
(786) 899-0686
NPI assigned
Dec 16, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 16, 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 PS33069 FL Primary

Addresses

Primary practice location

3135 Grand Ave
Miami, FL 33133-5103

Mailing address

15772 SW 24TH St
Miramar, FL 33027-4266
Phone (954) 253-4018

Other practice location 1

5850 NW 183rd St
Hialeah, FL 33015-6023
Phone (305) 819-0705

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
PS33069FLMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Grand 7TH Pharmacy and Discount LLC CurrentSince Dec 1, 2022 Accepting new patients
Grand 7TH Pharmacy by Kwik Stop LLC PastSince Dec 22, 2020 Accepting new patients

Locations

3135 Grand Ave
Miami, FL 33133
Phone (305) 445-7533

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": "1608076800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608076800000",
    "number": "1093301707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15772 SW 24TH ST",
            "city": "MIRAMAR",
            "state": "FL",
            "postal_code": "330274266",
            "telephone_number": "954-253-4018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3135 GRAND AVE",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331335103",
            "telephone_number": "305-445-7533",
            "fax_number": "786-899-0686"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5850 NW 183rd St",
            "address_purpose": "LOCATION",
            "city": "Hialeah",
            "state": "FL",
            "postal_code": "330156023",
            "country_code": "US",
            "telephone_number": "305-819-0705",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SALAMI",
        "first_name": "IMUENTINYAN",
        "middle_name": "SARIRATU",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-12-16",
        "last_updated": "2020-12-16",
        "certification_date": "2020-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "FL",
            "license": "PS33069",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 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.