Active NPI
Ren Ly
- Pharmacist
- Palm Harbor, FL
National Provider Identifier
1366228223
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PS66324
- Practice address
- 35439 US Highway 19 N
Palm Harbor, FL 34684-1737 - Phone
- (727) 771-9327
- NPI assigned
- Sep 6, 2023
- Sex
- Male
- Sole proprietor
- No
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 | PS66324 | FL | Primary |
Addresses
Primary practice location
35439 US Highway 19 N
Palm Harbor, FL 34684-1737
Mailing address
11339 Quiet Forest Dr
Tampa, FL 33635-6238
Phone (813) 390-5254
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PS66324 | FL | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1693958400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1693958400000",
"number": "1366228223",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11339 QUIET FOREST DR",
"city": "TAMPA",
"state": "FL",
"postal_code": "336356238",
"telephone_number": "813-390-5254"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "35439 US HIGHWAY 19 N",
"city": "PALM HARBOR",
"state": "FL",
"postal_code": "346841737",
"telephone_number": "727-771-9327"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LY",
"first_name": "REN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-09-06",
"last_updated": "2023-09-06",
"certification_date": "2023-09-06",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "FL",
"license": "PS66324",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Palm Harbor, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.