Latoy Renae Waite, PHARM.D.

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PS60016 Issued in FL

Practice address

2480 Tamiami TRL
Port Charlotte, FL 33952-3922

Phone

(941) 625-0023

NPI assigned

Jan 27, 2020

Last updated

Jan 27, 2020By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

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

{
    "created_epoch": "1580083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580083200000",
    "number": "1104457365",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17697 NW 19TH AVE",
            "city": "MIAMI GARDENS",
            "state": "FL",
            "postal_code": "330564816",
            "telephone_number": "786-985-8600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2480 TAMIAMI TRL",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "339523922",
            "telephone_number": "941-625-0023"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAITE",
        "first_name": "LATOY",
        "middle_name": "RENAE",
        "name_prefix": "Dr.",
        "credential": "PHARM.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-01-27",
        "last_updated": "2020-01-27",
        "certification_date": "2020-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "FL",
            "license": "PS60016",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NONE",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "https://www.linkedin.com/uas/login?session_redirect=https%3A%2F%2Fwww.linkedin.com%2Fme%2Fprofile-vi",
            "affiliation": "N",
            "endpointDescription": "LinkedIn Profile",
            "address_1": "2480 Tamiami Trl",
            "city": "Port Charlotte",
            "state": "FL",
            "country_code": "US",
            "postal_code": "339523922",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Lisa Marie Vullo, LCSW
• Svitlana O Wagner, MSN, FNP
• Sara Elizabeth Wainwright, PA-C
• Kyle Matthew Waisanen, MD
• Dylan Waite
• Wal-Mart Stores East LP (Walmart Pharmacy 10-3349)
• Wal-Mart Stores East LP (Walmart Pharmacy 10-0721)
• Wal-Mart Stores East LP (Walmart Pharmacy 10-6937)
• Wal-Mart Stores East, LP (Vision Center 30-0721)
• Wal-Mart Stores, Inc. (Vision Center 30-3349)

• Community/Retail Pharmacy in Port Charlotte, FL
• Providers in Port Charlotte, FL by specialty
• Community/Retail Pharmacy in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 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.