Individual provider Active NPI

Angelo A Fodor, PHARMD

  • Pharmacist
  • Vero Beach, FL
National Provider Identifier
1154762656
Registry record updated Jul 12, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PS36108 Issued in FL
Practice address
7040 61St St
Vero Beach, FL 32967-4928
Phone
(772) 766-2269
NPI assigned
Jul 12, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PS36108 FL Primary

Addresses

Primary practice location

7040 61St St
Vero Beach, FL 32967-4928

Mailing address

7040 61St St
Vero Beach, FL 32967-4928
Phone (772) 766-2269

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
PS36108FLMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1373587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1373587200000",
    "number": "1154762656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7040 61ST ST",
            "city": "VERO BEACH",
            "state": "FL",
            "postal_code": "329674928",
            "telephone_number": "772-766-2269"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7040 61ST ST",
            "city": "VERO BEACH",
            "state": "FL",
            "postal_code": "329674928",
            "telephone_number": "772-766-2269"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FODOR",
        "first_name": "ANGELO",
        "middle_name": "A",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-07-12",
        "last_updated": "2013-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "FL",
            "license": "PS36108",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vero Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2013; 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.