Individual provider Active NPI

Sean Tyrone Ustic, PHARMD

  • Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
  • Davenport, FL
National Provider Identifier
1144930850
Registry record updated Dec 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistTaxonomy code 1835P0018X
License
PS45386 Issued in FL
Practice address
40100 Highway 27
Davenport, FL 33837-5906
Phone
(863) 419-2366
NPI assigned
Dec 5, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist 1835P0018X PS45386 FL Primary

Addresses

Primary practice location

40100 Highway 27
Davenport, FL 33837-5906

Mailing address

616 Pointer LN
Lakeland, FL 33809-4630
Phone (520) 705-4255

Other practice location 1

13000 Bruce B Downs Blvd
Tampa, FL 33612-4745
Phone (520) 705-4255

Other identifiers 1

IdentifierTypeStateIssuer
PS45386OtherFLSTATE OF FLORIDA PHARMACY LICENSE

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address sean.ustic@adventhealth.com Direct

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
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
PS45386FLMDPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist

NPI Registry JSON

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

{
    "created_epoch": "1670198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670198400000",
    "number": "1144930850",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "616 POINTER LN",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338094630",
            "telephone_number": "520-705-4255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40100 HIGHWAY 27",
            "city": "DAVENPORT",
            "state": "FL",
            "postal_code": "338375906",
            "telephone_number": "863-419-2366"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13000 Bruce B Downs Blvd",
            "address_purpose": "LOCATION",
            "city": "Tampa",
            "state": "FL",
            "postal_code": "336124745",
            "country_code": "US",
            "telephone_number": "520-705-4255",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "USTIC",
        "first_name": "SEAN",
        "middle_name": "TYRONE",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-12-05",
        "last_updated": "2022-12-05",
        "certification_date": "2022-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "FL",
            "license": "PS45386",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF FLORIDA PHARMACY LICENSE",
            "identifier": "PS45386",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sean.ustic@adventhealth.com",
            "affiliation": "N",
            "endpointDescription": "adventhealth heart of florida email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "email",
            "address_1": "40100 Highway 27",
            "city": "Davenport",
            "state": "FL",
            "country_code": "US",
            "postal_code": "338375906",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Davenport, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 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.