Individual provider Active NPI

Jean Baptiste Stlouis

  • Pharmacy
  • North Miami, FL
National Provider Identifier
1104420207
Registry record updated Nov 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
Practice address
600 NE 128TH St
North Miami, FL 33161-4829
Phone
(305) 893-0560
NPI assigned
Nov 30, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 30, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X Primary

Addresses

Primary practice location

600 NE 128TH St
North Miami, FL 33161-4829

Mailing address

600 NE 128TH St
North Miami, FL 33161-4829

Other practice location 1

600 NE 128th St
North Miami, FL 33161-4829
Phone (305) 893-0560

Other identifiers 1

IdentifierTypeStateIssuer
1116901012MedicaidFL

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL Miramar

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

Practice roles

OrganizationSpecialtyStatusNew patients
Holiday CVS LLC Pharmacy PastSince Dec 6, 2020 Accepting new patients
Holiday CVS L.L.C. Pharmacy PastSince Dec 6, 2020 Accepting new patients

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": "1606694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606694400000",
    "number": "1104420207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 NE 128TH ST",
            "city": "NORTH MIAMI",
            "state": "FL",
            "postal_code": "331614829"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 NE 128TH ST",
            "city": "NORTH MIAMI",
            "state": "FL",
            "postal_code": "331614829",
            "telephone_number": "305-893-0560"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "600 NE 128th St",
            "address_purpose": "LOCATION",
            "city": "North Miami",
            "state": "FL",
            "postal_code": "331614829",
            "country_code": "US",
            "telephone_number": "305-893-0560",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STLOUIS",
        "first_name": "JEAN",
        "middle_name": "BAPTISTE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-11-30",
        "last_updated": "2020-11-30",
        "certification_date": "2020-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1116901012",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Miramar",
            "affiliation": "N",
            "address_1": "600 NE 128th St",
            "city": "North Miami",
            "state": "FL",
            "country_code": "US",
            "postal_code": "331614829",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in North Miami, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 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.