Individual provider Active NPI

Michelle Gonzalez Costa, RPH

  • Pharmacist
  • Miami, FL
National Provider Identifier
1407194731
Registry record updated Jan 21, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PS36983 Issued in FL
Practice address
4260 SW 152ND Ave
Miami, FL 33185-5252
Phone
(305) 222-8126
Fax
(305) 222-8110
NPI assigned
Jan 21, 2013
Last updated
Jan 21, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PS36983 FL Primary

Addresses

Primary practice location

4260 SW 152ND Ave
Miami, FL 33185-5252

Mailing address

4260 SW 152ND Ave
Miami, FL 33185-5252
Phone (305) 222-8126

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
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
PS36983FLMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1358726400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1358726400000",
    "number": "1407194731",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4260 SW 152ND AVE",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331855252",
            "telephone_number": "305-222-8126",
            "fax_number": "305-222-8110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4260 SW 152ND AVE",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331855252",
            "telephone_number": "305-222-8126",
            "fax_number": "305-222-8110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ COSTA",
        "first_name": "MICHELLE",
        "name_prefix": "Mrs.",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-01-21",
        "last_updated": "2013-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "FL",
            "license": "PS36983",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2013; 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.