Individual provider Active NPI

Brian Joseph Magsino Ilao

  • Pharmacist
  • Cape Coral, FL
National Provider Identifier
1104792688
Registry record updated Oct 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PS69428 Issued in FL
Practice address
1611 NE Pine Island Rd
Cape Coral, FL 33909-1797
Phone
(239) 242-1050
NPI assigned
Oct 13, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 13, 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 PS69428 FL Primary

Addresses

Primary practice location

1611 NE Pine Island Rd
Cape Coral, FL 33909-1797

Mailing address

8332 Free Ave
Jacksonville, FL 32211-9631
Phone (929) 471-1200

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
PS69428FLMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Holiday CVS LLC PastSince Oct 21, 2025 Accepting new patients
Holiday CVS L.L.C. PastSince Oct 21, 2025 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": "1760313600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760313600000",
    "number": "1104792688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8332 FREE AVE",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322119631",
            "telephone_number": "929-471-1200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1611 NE PINE ISLAND RD",
            "city": "CAPE CORAL",
            "state": "FL",
            "postal_code": "339091797",
            "telephone_number": "239-242-1050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ILAO",
        "first_name": "BRIAN JOSEPH",
        "middle_name": "MAGSINO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-10-13",
        "last_updated": "2025-10-13",
        "certification_date": "2025-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "FL",
            "license": "PS69428",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cape Coral, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 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.