Active NPI
Broderick Xavier Miles-Hibbert, PHARM D
- Pharmacist
- Boynton Beach, FL
National Provider Identifier
1194164822
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PS45402
- Practice address
- 10951 S Jog Rd
Boynton Beach, FL 33437-3921 - Phone
- (561) 734-6848
- NPI assigned
- Jun 15, 2013
- Last updated
- Jun 15, 2013
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | PS45402 | FL | Primary |
Addresses
Primary practice location
10951 S Jog Rd
Boynton Beach, FL 33437-3921
Mailing address
9837 Cobblestone Creek Dr
Boynton Beach, FL 33472-4453
Phone (561) 509-7983
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
| License | State | Type | Specialty |
|---|---|---|---|
| PS45402 | FL | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1371254400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1371254400000",
"number": "1194164822",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9837 COBBLESTONE CREEK DR",
"city": "BOYNTON BEACH",
"state": "FL",
"postal_code": "334724453",
"telephone_number": "561-509-7983"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10951 S JOG RD",
"city": "BOYNTON BEACH",
"state": "FL",
"postal_code": "334373921",
"telephone_number": "561-734-6848"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MILES-HIBBERT",
"first_name": "BRODERICK",
"middle_name": "XAVIER",
"name_prefix": "Dr.",
"credential": "PHARM D",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2013-06-15",
"last_updated": "2013-06-15",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "FL",
"license": "PS45402",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Boynton Beach, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 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.