NPIMap

Organization Active NPI

Florida Department of Veterans' Affairs

  • Department of Veterans Affairs (VA) Pharmacy
  • Port St. Luice, FL
National Provider Identifier
1356083075
Registry record updated Jul 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Department of Veterans Affairs (VA) PharmacyTaxonomy code 332100000X
Legal business name
FLORIDA DEPARTMENT OF VETERANS' AFFAIRS
Practice address
13000 SE Tradition Parkway
Port St. Luice, FL 34987
Phone
(772) 241-6132
NPI assigned
Apr 12, 2022
Organization subpart
Yes
Parent organization
FLORIDA DEPARTMENT OF VETERANS' AFFAIRSAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 8, 2026

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

Authorized official

Name
Connie Sue Tolley
Title
Director Fdva Homes
Phone
(727) 518-3203

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Department of Veterans Affairs (VA) Pharmacy 332100000X Primary

Addresses

Primary practice location

13000 SE Tradition Parkway
Port St. Luice, FL 34987

Mailing address

13000 SE Tradition Parkway
Port St. Luice, FL 34987
Phone (772) 241-6132

Other names 1

  • Ardie R. Copas State Veterans Nursing Home - Pharmacy Other name

National Provider Directory

National Provider Directory
Tax ID family
Florida Department of Veterans Affairs12 organizations share this tax ID, including this one
Part of
Florida Department of Veterans Affairs

Other organizations with this tax ID 11

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1649721600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1783468800000",
    "number": "1356083075",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13000 SE TRADITION PARKWAY",
            "city": "PORT ST. LUICE",
            "state": "FL",
            "postal_code": "34987",
            "telephone_number": "772-241-6132"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13000 SE TRADITION PARKWAY",
            "city": "PORT ST. LUICE",
            "state": "FL",
            "postal_code": "34987",
            "telephone_number": "772-241-6132"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FLORIDA DEPARTMENT OF VETERANS' AFFAIRS",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FLORIDA DEPARTMENT OF VETERANS' AFFAIRS",
        "enumeration_date": "2022-04-12",
        "last_updated": "2026-07-08",
        "certification_date": "2026-07-08",
        "status": "A",
        "authorized_official_last_name": "TOLLEY",
        "authorized_official_first_name": "CONNIE",
        "authorized_official_middle_name": "SUE",
        "authorized_official_title_or_position": "DIRECTOR FDVA HOMES",
        "authorized_official_telephone_number": "727-518-3203"
    },
    "taxonomies": [
        {
            "code": "332100000X",
            "taxonomy_group": "",
            "desc": "Department of Veterans Affairs (VA) Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ardie R. Copas State Veterans Nursing Home - Pharmacy",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Port St. Luice, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2026; 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.