Individual provider Active NPI

Kristal Stephany Urena Potter, PHARMD

  • Pharmacist
  • Miami, FL
National Provider Identifier
1164074316
Registry record updated Feb 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PS59472 Issued in FL
Practice address
18301 N Miami Ave # 1
Miami, FL 33169-4564
Phone
(305) 760-7486
NPI assigned
Jul 9, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PS59472 FL Primary

Addresses

Primary practice location

18301 N Miami Ave # 1
Miami, FL 33169-4564

Mailing address

632 NW 46TH Ave
Deerfield Beach, FL 33442-9373
Phone (954) 479-0866

Other names 1

  • Kristal Stephany Urena Former name

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
PS59472FLMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1562630400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676419200000",
    "number": "1164074316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "632 NW 46TH AVE",
            "city": "DEERFIELD BEACH",
            "state": "FL",
            "postal_code": "334429373",
            "telephone_number": "954-479-0866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18301 N MIAMI AVE # 1",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331694564",
            "telephone_number": "305-760-7486"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POTTER",
        "first_name": "KRISTAL",
        "middle_name": "STEPHANY URENA",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-09",
        "last_updated": "2023-02-15",
        "certification_date": "2023-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "FL",
            "license": "PS59472",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTAL",
            "last_name": "URENA",
            "middle_name": "STEPHANY",
            "credential": "PHARMD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Miami, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2023; 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.