Active NPI
Serge Michel
- Pharmacist
- Miami Gardens, FL
National Provider Identifier
1134096779
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PS69746
- Practice address
- 3700 NW 199TH St
Miami Gardens, FL 33055-1444 - Phone
- (305) 430-9170
- Fax
- (305) 430-9073
- NPI assigned
- Oct 20, 2025
- Last updated
- Oct 20, 2025
- Sex
- Male
- Sole proprietor
- Yes
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 | PS69746 | FL | Primary |
Addresses
Primary practice location
3700 NW 199TH St
Miami Gardens, FL 33055-1444
Mailing address
3700 NW 199TH St
Miami Gardens, FL 33055-1444
Phone (305) 430-9170
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
| License | State | Type | Specialty |
|---|---|---|---|
| PS69746 | FL | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Holiday CVS LLC | Past | Accepting new patients | |
| Holiday CVS L.L.C. | Past | 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, 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": "1760918400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1760918400000",
"number": "1134096779",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3700 NW 199TH ST",
"city": "MIAMI GARDENS",
"state": "FL",
"postal_code": "330551444",
"telephone_number": "305-430-9170",
"fax_number": "305-430-9073"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3700 NW 199TH ST",
"city": "MIAMI GARDENS",
"state": "FL",
"postal_code": "330551444",
"telephone_number": "305-430-9170",
"fax_number": "305-430-9073"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MICHEL",
"first_name": "SERGE",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2025-10-20",
"last_updated": "2025-10-20",
"certification_date": "2025-10-20",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Pharmacist",
"state": "FL",
"license": "PS69746",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Miami Gardens, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.