Individual provider Active NPI

Raelea Sharon Derylak

  • Pharmacist
  • Tampa, FL
National Provider Identifier
1144101510
Registry record updated Sep 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PS69425 Issued in FL
Practice address
5357 Ehrlich Rd
Tampa, FL 33625-5505
Phone
(813) 968-4003
NPI assigned
Sep 10, 2025
Last updated
Sep 10, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PS69425 FL Primary

Addresses

Primary practice location

5357 Ehrlich Rd
Tampa, FL 33625-5505

Mailing address

6207 S West Shore Blvd Apt 2063
Tampa, FL 33616-1652

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
PS69425FLMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1757462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757462400000",
    "number": "1144101510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6207 S WEST SHORE BLVD APT 2063",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336161652"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5357 EHRLICH RD",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336255505",
            "telephone_number": "813-968-4003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DERYLAK",
        "first_name": "RAELEA",
        "middle_name": "SHARON",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-09-10",
        "last_updated": "2025-09-10",
        "certification_date": "2025-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "FL",
            "license": "PS69425",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 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.

Verify at the official NPI Registry.