Individual provider Active NPI

Victor Emmanuel Maldonado Reyes, PHARMD

  • Pharmacist
  • Miami, FL
National Provider Identifier
1114523578
Registry record updated Dec 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PS53833 Issued in FL
Practice address
10201 Hammocks Blvd Ste 112
Miami, FL 33196-3780
Phone
(305) 286-8381
NPI assigned
Dec 9, 2020
Last updated
Dec 9, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PS53833 FL Primary

Addresses

Primary practice location

10201 Hammocks Blvd Ste 112
Miami, FL 33196-3780

Mailing address

125 NE 32ND St Apt 1517
Miami, FL 33137-4351
Phone (787) 615-2883

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
PS53833FLMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1607472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607472000000",
    "number": "1114523578",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 NE 32ND ST APT 1517",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331374351",
            "telephone_number": "787-615-2883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10201 HAMMOCKS BLVD STE 112",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331963780",
            "telephone_number": "305-286-8381"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALDONADO REYES",
        "first_name": "VICTOR",
        "middle_name": "EMMANUEL",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-12-09",
        "last_updated": "2020-12-09",
        "certification_date": "2020-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "FL",
            "license": "PS53833",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 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.