Individual provider Active NPI

Ilona Gorelashvili

  • Pharmacist
  • Sunny Isles Beach, FL
National Provider Identifier
1164827630
Registry record updated Oct 27, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PS52647 Issued in FL
Practice address
16711 Collins Ave Apt 1507
Sunny Isles Beach, FL 33160-4293
Phone
(718) 844-9817
NPI assigned
Oct 27, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 27, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PS52647 FL Primary
Pharmacist 183500000X 059678 NY

Addresses

Primary practice location

16711 Collins Ave Apt 1507
Sunny Isles Beach, FL 33160-4293

Mailing address

16711 Collins Ave Apt 1507
Sunny Isles Beach, FL 33160-4293
Phone (718) 844-9817

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
PS52647FLMDPharmacist
059678NYMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1414368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1414368000000",
    "number": "1164827630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16711 COLLINS AVE APT 1507",
            "city": "SUNNY ISLES BEACH",
            "state": "FL",
            "postal_code": "331604293",
            "telephone_number": "718-844-9817"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16711 COLLINS AVE APT 1507",
            "city": "SUNNY ISLES BEACH",
            "state": "FL",
            "postal_code": "331604293",
            "telephone_number": "718-844-9817"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORELASHVILI",
        "first_name": "ILONA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-10-27",
        "last_updated": "2014-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "FL",
            "license": "PS52647",
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "059678",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sunny Isles Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2014; 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.