Consollar Leeds Azenui

Primary specialty

PharmacistTaxonomy code 183500000X

License

24001 Issued in MD

Practice address

60 Shining Willow Way
La Plata, MD 20646-4224

Phone

(301) 934-5910

NPI assigned

Aug 27, 2020

Sex

Female

Sole proprietor

No

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Aug 27, 2020.

{
    "created_epoch": "1598486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598486400000",
    "number": "1124631346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2709 ZEEK LN",
            "city": "LANHAM",
            "state": "MD",
            "postal_code": "207061400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "60 SHINING WILLOW WAY",
            "city": "LA PLATA",
            "state": "MD",
            "postal_code": "206464224",
            "telephone_number": "301-934-5910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AZENUI",
        "first_name": "CONSOLLAR",
        "middle_name": "LEEDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-27",
        "last_updated": "2020-08-27",
        "certification_date": "2020-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MD",
            "license": "24001",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in La Plata, MD
• Pharmacist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 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.