Active NPI
Genesis Carrillo
- Pharmacist
- Bradenton, FL
National Provider Identifier
1104431964
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PS61535
- Practice address
- 4210 E, FL-64
Bradenton, FL 34208 - Phone
- (941) 708-9161
- NPI assigned
- Sep 9, 2020
- 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 | PS61535 | FL | Primary |
Addresses
Primary practice location
4210 E, FL-64
Bradenton, FL 34208
Mailing address
4210 E, FL-64
Bradenton, FL 34208
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 |
|---|---|---|---|
| PS61535 | FL | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1599609600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1599696000000",
"number": "1104431964",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4210 E, FL-64",
"city": "BRADENTON",
"state": "FL",
"postal_code": "34208"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4210 E, FL-64",
"city": "BRADENTON",
"state": "FL",
"postal_code": "34208",
"telephone_number": "941-708-9161"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CARRILLO",
"first_name": "GENESIS",
"name_prefix": "Dr.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-09-09",
"last_updated": "2020-09-10",
"certification_date": "2020-09-10",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "FL",
"license": "PS61535",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bradenton, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 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.