Active NPI
Ulecia Boldin, PHARM D
- Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
- Port St Lucie, FL
National Provider Identifier
1376129122
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
- License
- PS48022
- Practice address
- 280 SW Port St Lucie Blvd
Port St Lucie, FL 34984-5044 - Phone
- (772) 878-6353
- NPI assigned
- Mar 22, 2021
- Last updated
- Mar 22, 2021
- 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 Clinician (PhC)/ Clinical Pharmacy Specialist | 1835P0018X | PS48022 | FL | Primary |
Addresses
Primary practice location
280 SW Port St Lucie Blvd
Port St Lucie, FL 34984-5044
Mailing address
280 SW Port St Lucie Blvd
Port St Lucie, FL 34984-5044
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | rxm.04001@store.walgreens.com | WALGREEN CO |
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
| License | State | Type | Specialty |
|---|---|---|---|
| PS48022 | FL | MD | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | Past | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1616371200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1616371200000",
"number": "1376129122",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "280 SW PORT ST LUCIE BLVD",
"city": "PORT ST LUCIE",
"state": "FL",
"postal_code": "349845044"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "280 SW PORT ST LUCIE BLVD",
"city": "PORT ST LUCIE",
"state": "FL",
"postal_code": "349845044",
"telephone_number": "772-878-6353"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOLDIN",
"first_name": "ULECIA",
"name_prefix": "Dr.",
"credential": "PHARM D",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-03-22",
"last_updated": "2021-03-22",
"certification_date": "2021-03-22",
"status": "A"
},
"taxonomies": [
{
"code": "1835P0018X",
"taxonomy_group": "",
"desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
"state": "FL",
"license": "PS48022",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "rxm.04001@store.walgreens.com",
"affiliation": "Y",
"affiliationName": "WALGREEN CO",
"address_1": "280 SW Port St Lucie Blvd",
"city": "Port St Lucie",
"state": "FL",
"country_code": "US",
"postal_code": "349845044",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Port St Lucie, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.