Individual provider Active NPI

Lynette Carole Boodhoo, RPH

  • Pharmacist
  • Cutler Bay, FL
National Provider Identifier
1265684435
Registry record updated Oct 18, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PU5250 Issued in FL
Practice address
10300 SW 216TH St
Cutler Bay, FL 33190-1003
Phone
(305) 254-7166
Fax
(305) 254-7795
NPI assigned
Oct 18, 2008
Last updated
Oct 18, 2008By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 18, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PU5250 FL Primary
Pharmacist 183500000X PS 24489 FL

Addresses

Primary practice location

10300 SW 216TH St
Cutler Bay, FL 33190-1003

Mailing address

10300 SW 216TH St
Cutler Bay, FL 33190-1003
Phone (305) 254-7166

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
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
PS 24489FLMDPharmacist
PU5250FLMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1224288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1224288000000",
    "number": "1265684435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10300 SW 216TH ST",
            "city": "CUTLER BAY",
            "state": "FL",
            "postal_code": "331901003",
            "telephone_number": "305-254-7166",
            "fax_number": "305-254-7795"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10300 SW 216TH ST",
            "city": "CUTLER BAY",
            "state": "FL",
            "postal_code": "331901003",
            "telephone_number": "305-254-7166",
            "fax_number": "305-254-7795"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOODHOO",
        "first_name": "LYNETTE",
        "middle_name": "CAROLE",
        "name_prefix": "Mrs.",
        "credential": "RPH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-10-18",
        "last_updated": "2008-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "FL",
            "license": "PU5250",
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "FL",
            "license": "PS 24489",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cutler Bay, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 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.