Active NPI
Nicole Maksutovic, PHARMD
- Pharmacist
- West Palm Beach, FL
National Provider Identifier
1386249381
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PS60860
- Practice address
- 1301 N Dixie Hwy
West Palm Beach, FL 33401-2703 - Phone
- (561) 366-1125
- Fax
- (561) 366-3609
- NPI assigned
- Nov 30, 2020
- Last updated
- Nov 30, 2020
- 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 | PS60860 | FL | Primary |
Addresses
Primary practice location
1301 N Dixie Hwy
West Palm Beach, FL 33401-2703
Mailing address
1301 N Dixie Hwy
West Palm Beach, FL 33401-2703
Phone (561) 366-1125
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 |
|---|---|---|---|
| PS60860 | FL | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Holiday CVS LLC | Past | Accepting new patients | |
| Holiday CVS L.L.C. | 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": "1606694400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1606694400000",
"number": "1386249381",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1301 N DIXIE HWY",
"city": "WEST PALM BEACH",
"state": "FL",
"postal_code": "334012703",
"telephone_number": "561-366-1125",
"fax_number": "561-366-3609"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1301 N DIXIE HWY",
"city": "WEST PALM BEACH",
"state": "FL",
"postal_code": "334012703",
"telephone_number": "561-366-1125",
"fax_number": "561-366-3609"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAKSUTOVIC",
"first_name": "NICOLE",
"name_prefix": "Dr.",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-11-30",
"last_updated": "2020-11-30",
"certification_date": "2020-11-30",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "FL",
"license": "PS60860",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in West Palm Beach, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.