Active NPI
Suzanne Pedersen
- Pharmacist
- Sarasota, FL
National Provider Identifier
1366780975
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PS21184
- Practice address
- 4840 S Tamiami TRL
Sarasota, FL 34231-4352 - Phone
- (941) 927-9651
- NPI assigned
- Jan 17, 2013
- Sex
- Female
- 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 | PS21184 | FL | Primary |
Addresses
Primary practice location
4840 S Tamiami TRL
Sarasota, FL 34231-4352
Mailing address
2374 Datura St
Sarasota, FL 34239-3915
Phone (941) 366-9657
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PS21184 | Other | FL | STATE LICENSE |
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 |
|---|---|---|---|
| PS21184 | FL | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1358380800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1358380800000",
"number": "1366780975",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2374 DATURA ST",
"city": "SARASOTA",
"state": "FL",
"postal_code": "342393915",
"telephone_number": "941-366-9657"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4840 S TAMIAMI TRL",
"city": "SARASOTA",
"state": "FL",
"postal_code": "342314352",
"telephone_number": "941-927-9651"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PEDERSEN",
"first_name": "SUZANNE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-01-17",
"last_updated": "2013-01-17",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "FL",
"license": "PS21184",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENSE",
"identifier": "PS21184",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Sarasota, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.