Individual provider Active NPI

Raywood W Borel, PHARM.D.

  • Pharmacist
  • Tyndall Afb, FL
National Provider Identifier
1396806014
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PS33876 Issued in FL
Practice address
340 Magnolia Cir
325TH MDSS SGSP
Tyndall Afb, FL 32403-5604
Phone
(850) 283-7480
NPI assigned
Dec 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PS33876 FL Primary
Pharmacist 183500000X RPH019579 GA

Addresses

Primary practice location

340 Magnolia Cir
325TH MDSS SGSP
Tyndall Afb, FL 32403-5604

Mailing address

340 Magnolia Cir
325 MDSS-SGSP
Tyndall Afb, FL 32403-5604
Phone (850) 283-7480

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

LicenseStateTypeSpecialty
PS33876FLMDPharmacist
RPH019579GAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1165968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1396806014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "340 MAGNOLIA CIR",
            "address_2": "325 MDSS-SGSP",
            "city": "TYNDALL AFB",
            "state": "FL",
            "postal_code": "324035604",
            "telephone_number": "850-283-7480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "340 MAGNOLIA CIR",
            "address_2": "325TH MDSS SGSP",
            "city": "TYNDALL AFB",
            "state": "FL",
            "postal_code": "324035604",
            "telephone_number": "850-283-7480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOREL",
        "first_name": "RAYWOOD",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "PHARM.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "FL",
            "license": "PS33876",
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "GA",
            "license": "RPH019579",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tyndall Afb, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.