Individual provider Active NPI

Minimol Kuriakose, RPH

  • Pharmacist
  • Zephyrhills, FL
National Provider Identifier
1417766684
Registry record updated Jan 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PS35332 Issued in FL
Practice address
35780 State Road 54 Ste 101
Zephyrhills, FL 33541-2242
Phone
(813) 782-4854
Fax
(813) 782-4856
NPI assigned
Jan 2, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 2, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PS35332 FL Primary

Addresses

Primary practice location

35780 State Road 54 Ste 101
Zephyrhills, FL 33541-2242

Mailing address

35780 State Road 54 Ste 101
Zephyrhills, FL 33541-2242
Phone (813) 782-4854

Other practice location 1

8811 State Road 52 Ste 11
Hudson, FL 34667-6751
Phone (727) 233-9908

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
PS35332FLMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
St Joseph Pharmacy & Medical Supplies LLC CurrentSince Jan 5, 2025 Accepting new patients
St. Joseph's Pharmacy and Medical Supplies, LLC Current Accepting new patients
Lily Care LLC Past Accepting new patients

Locations

35780 Pure Water Way
Ste 101
Zephyrhills, FL 33541
Phone (813) 782-4854

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1735776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735776000000",
    "number": "1417766684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35780 STATE ROAD 54 STE 101",
            "city": "ZEPHYRHILLS",
            "state": "FL",
            "postal_code": "335412242",
            "telephone_number": "813-782-4854",
            "fax_number": "813-782-4856"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35780 STATE ROAD 54 STE 101",
            "city": "ZEPHYRHILLS",
            "state": "FL",
            "postal_code": "335412242",
            "telephone_number": "813-782-4854",
            "fax_number": "813-782-4856"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8811 State Road 52 Ste 11",
            "address_purpose": "LOCATION",
            "city": "Hudson",
            "state": "FL",
            "postal_code": "346676751",
            "country_code": "US",
            "telephone_number": "727-233-9908",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KURIAKOSE",
        "first_name": "MINIMOL",
        "credential": "RPH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-01-02",
        "last_updated": "2025-01-02",
        "certification_date": "2025-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "FL",
            "license": "PS35332",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Zephyrhills, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2025; 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.