Individual provider Active NPI

Kenneth Salvatore Dimarco, PHARMD

  • Student in an Organized Health Care Education/Training Program
  • Riverview, FL
National Provider Identifier
1235306515
Registry record updated May 14, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
License
PSI18653 Issued in FL
Practice address
2760 S Falkenburg Rd
Riverview, FL 33578-2561
Phone
(813) 621-6041
NPI assigned
May 14, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 14, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X PSI18653 FL Primary

Addresses

Primary practice location

2760 S Falkenburg Rd
Riverview, FL 33578-2561

Mailing address

19127 Larchmont Dr
Odessa, FL 33556-2269

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
PSI18653FLMDStudent in an Organized Health Care Education/Training Program

NPI Registry JSON

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

{
    "created_epoch": "1210723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1210723200000",
    "number": "1235306515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19127 LARCHMONT DR",
            "city": "ODESSA",
            "state": "FL",
            "postal_code": "335562269"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2760 S FALKENBURG RD",
            "city": "RIVERVIEW",
            "state": "FL",
            "postal_code": "335782561",
            "telephone_number": "813-621-6041"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIMARCO",
        "first_name": "KENNETH",
        "middle_name": "SALVATORE",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-05-14",
        "last_updated": "2008-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "FL",
            "license": "PSI18653",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverview, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2008; 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.