Individual provider Active NPI

Yaniset Fundora, PHARMD

  • Pharmacist
  • Miami, FL
National Provider Identifier
1295461366
Registry record updated Jul 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PS64143 Issued in FL
Practice address
655 NW 57TH Ave
Miami, FL 33126-4814
Phone
(786) 388-1466
Fax
(786) 388-9209
NPI assigned
Jul 29, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PS64143 FL Primary

Addresses

Primary practice location

655 NW 57TH Ave
Miami, FL 33126-4814

Mailing address

655 NW 57TH Ave
Miami, FL 33126-4814
Phone (786) 388-1466

Other practice location 1

655 nw 57th ave
miami, FL 33126-4814
Phone (786) 388-1466

Other practice location 2

655 NW 57th Ave
Miami, FL 33126-4814
Phone (786) 388-1466

Other practice location 3

655 NW 57th Ave
Miami, FL 33126-4814

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
PS64143FLMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Walgreen Co PastSince Jul 31, 2022 Accepting new patients
Walgreen Co PastSince Jul 31, 2022 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1659052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659052800000",
    "number": "1295461366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "655 NW 57TH AVE",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331264814",
            "telephone_number": "786-388-1466",
            "fax_number": "786-388-9209"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "655 NW 57TH AVE",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331264814",
            "telephone_number": "786-388-1466",
            "fax_number": "786-388-9209"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "655 nw 57th ave",
            "address_purpose": "LOCATION",
            "city": "miami",
            "state": "FL",
            "postal_code": "331264814",
            "country_code": "US",
            "telephone_number": "786-388-1466",
            "fax_number": "786-388-9209",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "655 NW 57th Ave",
            "address_purpose": "LOCATION",
            "city": "Miami",
            "state": "FL",
            "postal_code": "331264814",
            "country_code": "US",
            "telephone_number": "786-388-1466",
            "fax_number": "786-388-9209",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "655 NW 57th Ave",
            "address_purpose": "LOCATION",
            "city": "Miami",
            "state": "FL",
            "postal_code": "331264814",
            "country_code": "US",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FUNDORA",
        "first_name": "YANISET",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-29",
        "last_updated": "2022-07-29",
        "certification_date": "2022-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "FL",
            "license": "PS64143",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2022; 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.