Individual provider Active NPI

Leonid Markov, PHARMD

  • Pharmacist
  • Fort Lauderdale, FL
National Provider Identifier
1154793909
Registry record updated Oct 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
18612 Issued in NV
Practice address
3540 NW 56TH St Ste 204
Fort Lauderdale, FL 33309-2260
Phone
(877) 367-3479
Fax
(833) 347-9329
NPI assigned
Oct 20, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 18612 NV Primary

Addresses

Primary practice location

3540 NW 56TH St Ste 204
Fort Lauderdale, FL 33309-2260

Mailing address

11001 S Eastern Ave
Henderson, NV 89052-2954
Phone (702) 948-8355

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
18612NVMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Direct Pharmacy Source, Inc CurrentSince Oct 6, 2024 Accepting new patients
Walgreen Co Past Accepting new patients
Walgreen Co Past Accepting new patients

Locations

3540 NW 56th St
Ste 204
Fort Lauderdale, FL 33309
Phone (877) 367-3479

Organizations & group practices 3

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": "1445299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727740800000",
    "number": "1154793909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11001 S EASTERN AVE",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890522954",
            "telephone_number": "702-948-8355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3540 NW 56TH ST STE 204",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333092260",
            "telephone_number": "877-367-3479",
            "fax_number": "833-347-9329"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARKOV",
        "first_name": "LEONID",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-10-20",
        "last_updated": "2024-10-01",
        "certification_date": "2024-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NV",
            "license": "18612",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Lauderdale, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2024; 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.