Active NPI
Angela C Chiu, PHARMD, RPH
- Pharmacist
- Mount Dora, FL
National Provider Identifier
1386261303
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PS53871
- Practice address
- 18910 US Highway 441
Mount Dora, FL 32757-6736 - Phone
- (352) 735-0600
- NPI assigned
- Jun 26, 2020
- Last updated
- Jun 26, 2020
- Sex
- Female
- Sole proprietor
- Yes
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 | PS53871 | FL | Primary |
Addresses
Primary practice location
18910 US Highway 441
Mount Dora, FL 32757-6736
Mailing address
3307 Wolf Run Rd
Mount Dora, FL 32757-9741
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PS53871 | Other | FL | DEPARTMENT OF HEALTH, FLORIDA |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | mgr.02928@store.walgreens.com |
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, Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PS53871 | FL | MD | Pharmacist |
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": "1593129600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1593129600000",
"number": "1386261303",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3307 WOLF RUN RD",
"city": "MOUNT DORA",
"state": "FL",
"postal_code": "327579741"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "18910 US HIGHWAY 441",
"city": "MOUNT DORA",
"state": "FL",
"postal_code": "327576736",
"telephone_number": "352-735-0600"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHIU",
"first_name": "ANGELA",
"middle_name": "C",
"credential": "PHARMD, RPH",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-06-26",
"last_updated": "2020-06-26",
"certification_date": "2020-06-26",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "FL",
"license": "PS53871",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DEPARTMENT OF HEALTH, FLORIDA",
"identifier": "PS53871",
"state": "FL"
}
],
"endpoints": [
{
"endpointType": "OTHERS",
"endpointTypeDescription": "Other URL",
"endpoint": "mgr.02928@store.walgreens.com",
"affiliation": "N",
"address_1": "18910 US Highway 441",
"city": "Mount Dora",
"state": "FL",
"country_code": "US",
"postal_code": "327576736",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Mount Dora, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 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.