Individual provider Active NPI

Modupe Olusola Alle, PHARMD

  • Pharmacist
  • Hialeah, FL
National Provider Identifier
1184273203
Registry record updated Sep 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PS59959 Issued in FL
Practice address
19170 NW 88TH CT
Hialeah, FL 33018-6241
Phone
(305) 984-1958
NPI assigned
Sep 11, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 11, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PS59959 FL Primary

Addresses

Primary practice location

19170 NW 88TH CT
Hialeah, FL 33018-6241

Mailing address

19170 NW 88TH CT
Hialeah, FL 33018-6241
Phone (305) 984-1958

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
PS59959FLMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1568160000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568160000000",
    "number": "1184273203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19170 NW 88TH CT",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330186241",
            "telephone_number": "305-984-1958"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19170 NW 88TH CT",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330186241",
            "telephone_number": "305-984-1958"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALLE",
        "first_name": "MODUPE",
        "middle_name": "OLUSOLA",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-09-11",
        "last_updated": "2019-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "FL",
            "license": "PS59959",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hialeah, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2019; 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.