Individual provider Active NPI

Paresh Shukla

  • Pharmacist
  • St Petersburg, FL
National Provider Identifier
1114673399
Registry record updated Feb 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PS31362 Issued in FL
Practice address
1617 34TH St S Ste a
St Petersburg, FL 33711-2855
Phone
(727) 327-9881
NPI assigned
Feb 25, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 25, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PS31362 FL Primary

Addresses

Primary practice location

1617 34TH St S Ste a
St Petersburg, FL 33711-2855

Mailing address

10105 Queens Park Dr
Tampa, FL 33647-3166
Phone (727) 327-9881

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
PS31362FLMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Urban Specialty Pharmacy LLC CurrentSince Jul 24, 2022 Accepting new patients

Locations

1617 34th St S
Ste A
St Petersburg, FL 33711
Phone (727) 327-9881

Organizations & group practices 1

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": "1645747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645747200000",
    "number": "1114673399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10105 QUEENS PARK DR",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336473166",
            "telephone_number": "727-327-9881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1617 34TH ST S STE A",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337112855",
            "telephone_number": "727-327-9881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHUKLA",
        "first_name": "PARESH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-02-25",
        "last_updated": "2022-02-25",
        "certification_date": "2022-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "FL",
            "license": "PS31362",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Petersburg, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2022; 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.