Aetna Specialty Pharmacy

Primary specialty

Preferred Provider OrganizationTaxonomy code 305R00000X

Legal business name

AETNA SPECIALTY PHARMACY

Practice address

503 Sunport LN
Orlando, FL 32809-7874

Phone

(407) 513-1880

NPI assigned

Mar 12, 2014

Organization subpart

No

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

Authorized official

Name

Nereida Padilla, RPH

Title

Pharmacist in Charge

Phone

(407) 513-8626

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1394582400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1394582400000",
    "number": "1386060580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "503 SUNPORT LN",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328097874"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "503 SUNPORT LN",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328097874",
            "telephone_number": "407-513-1880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AETNA SPECIALTY PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-03-12",
        "last_updated": "2014-03-12",
        "status": "A",
        "authorized_official_last_name": "PADILLA",
        "authorized_official_first_name": "NEREIDA",
        "authorized_official_title_or_position": "PHARMACIST IN CHARGE",
        "authorized_official_telephone_number": "407-513-8626",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "305R00000X",
            "taxonomy_group": "",
            "desc": "Preferred Provider Organization",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Preferred Provider Organization in Orlando, FL
• Providers in Orlando, FL by specialty
• Preferred Provider Organization in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2014; 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.