Active NPI
Benjamin Lee, RPH
- Pharmacist
- Riverview, FL
National Provider Identifier
1114513397
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PS40938
- Practice address
- 10623 Gibsonton Dr
Riverview, FL 33578-5404 - Phone
- (813) 677-4435
- NPI assigned
- Dec 12, 2020
- Last updated
- Dec 12, 2020
- Sex
- Male
- 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 | PS40938 | FL | Primary |
Addresses
Primary practice location
10623 Gibsonton Dr
Riverview, FL 33578-5404
Mailing address
3201 Stagecoach TRL
Wimauma, FL 33598-7526
Phone (313) 580-2547
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
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PS40938 | FL | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Holiday CVS LLC | Current | Accepting new patients | |
| Holiday CVS L.L.C. | Past | Accepting new patients |
Locations
10623 Gibsonton Dr
Riverview, FL 33578
Phone (813) 677-4435
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1607731200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1607731200000",
"number": "1114513397",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3201 STAGECOACH TRL",
"city": "WIMAUMA",
"state": "FL",
"postal_code": "335987526",
"telephone_number": "313-580-2547"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10623 GIBSONTON DR",
"city": "RIVERVIEW",
"state": "FL",
"postal_code": "335785404",
"telephone_number": "813-677-4435"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEE",
"first_name": "BENJAMIN",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-12-12",
"last_updated": "2020-12-12",
"certification_date": "2020-12-12",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "FL",
"license": "PS40938",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Riverview, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 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.