Individual provider Active NPI

Yelisa Enid Reyes Hernandez, PHARMD

  • Pharmacist
  • Seffner, FL
National Provider Identifier
1104610047
Registry record updated Apr 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PS68443 Issued in FL
Practice address
704 W Dr Martin Luther King Jr Blvd
Seffner, FL 33584-4534
Phone
(813) 681-4431
NPI assigned
Apr 7, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PS68443 FL Primary

Addresses

Primary practice location

704 W Dr Martin Luther King Jr Blvd
Seffner, FL 33584-4534

Mailing address

10202 Mangrove Well Rd
Sun City Center, FL 33573-6681
Phone (787) 674-8556

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
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
PS68443FLMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1743984000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743984000000",
    "number": "1104610047",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10202 MANGROVE WELL RD",
            "city": "SUN CITY CENTER",
            "state": "FL",
            "postal_code": "335736681",
            "telephone_number": "787-674-8556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "704 W DR MARTIN LUTHER KING JR BLVD",
            "city": "SEFFNER",
            "state": "FL",
            "postal_code": "335844534",
            "telephone_number": "813-681-4431"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYES HERNANDEZ",
        "first_name": "YELISA",
        "middle_name": "ENID",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-04-07",
        "last_updated": "2025-04-07",
        "certification_date": "2025-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "FL",
            "license": "PS68443",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seffner, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2025; 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.