Active NPI
Mark D Porcelli, RPH
- Pharmacist
- Sunrise, FL
National Provider Identifier
1427150176
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PS21058
- Practice address
- 4201 NW 88 Ave
Sunrise, FL 33351 - Phone
- (954) 749-6965
- Fax
- (954) 749-6138
- NPI assigned
- Sep 2, 2006
- Last updated
- Mar 18, 2011
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | PS21058 | FL | Primary |
| Pharmacist | 183500000X | 035822-1 | NY |
Addresses
Primary practice location
4201 NW 88 Ave
Sunrise, FL 33351
Mailing address
4201 NW 88 Avenue
Sunrise, FL 33351
Phone (954) 749-6965
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
| License | State | Type | Specialty |
|---|---|---|---|
| PS21058 | FL | MD | Pharmacist |
| 035822-1 | NY | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1157155200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1300406400000",
"number": "1427150176",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4201 NW 88 AVENUE",
"city": "SUNRISE",
"state": "FL",
"postal_code": "33351",
"telephone_number": "954-749-6965",
"fax_number": "954-749-6138"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4201 NW 88 AVE",
"city": "SUNRISE",
"state": "FL",
"postal_code": "33351",
"telephone_number": "954-749-6965",
"fax_number": "954-749-6138"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PORCELLI",
"first_name": "MARK",
"middle_name": "D",
"name_prefix": "Mr.",
"credential": "RPH",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-09-02",
"last_updated": "2011-03-18",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "FL",
"license": "PS21058",
"primary": true
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NY",
"license": "035822-1",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sunrise, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.