Individual provider Active NPI

Sameer Maniktala

  • Pharmacist
  • Fort Myers, FL
National Provider Identifier
1124661137
Registry record updated Oct 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PS37192 Issued in FL
Practice address
9131 College Pkwy
Fort Myers, FL 33919-5818
Phone
(239) 267-2032
NPI assigned
Oct 22, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PS37192 FL Primary

Addresses

Primary practice location

9131 College Pkwy
Fort Myers, FL 33919-5818

Mailing address

14501 Reflection Lakes Dr
Fort Myers, FL 33907-1814
Phone (347) 512-7061

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
PS37192FLMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Wal-Mart Stores East LP PastSince Oct 27, 2019 Accepting new patients
Wal-Mart Stores East, LP PastSince Oct 27, 2019 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": "1571702400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571702400000",
    "number": "1124661137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14501 REFLECTION LAKES DR",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339071814",
            "telephone_number": "347-512-7061"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9131 COLLEGE PKWY",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339195818",
            "telephone_number": "239-267-2032"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANIKTALA",
        "first_name": "SAMEER",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-10-22",
        "last_updated": "2019-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "FL",
            "license": "PS37192",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Myers, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2019; 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.