Individual provider Active NPI

Tara Nicole La Salle

  • Pharmacist
  • Oviedo, FL
National Provider Identifier
1427655588
Registry record updated Oct 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PS60283 Issued in FL
Practice address
443 County Rd 419 Ste 1001
Oviedo, FL 32766
Phone
(407) 366-4727
NPI assigned
Oct 1, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PS60283 FL Primary

Addresses

Primary practice location

443 County Rd 419 Ste 1001
Oviedo, FL 32766

Mailing address

2235 Corbett Rd
Orlando, FL 32826-4909
Phone (727) 946-0785

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

State licenses

LicenseStateTypeSpecialty
PS60283FLMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1601510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601510400000",
    "number": "1427655588",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2235 CORBETT RD",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328264909",
            "telephone_number": "727-946-0785"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "443 COUNTY RD 419 STE 1001",
            "city": "OVIEDO",
            "state": "FL",
            "postal_code": "32766",
            "telephone_number": "407-366-4727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LA SALLE",
        "first_name": "TARA",
        "middle_name": "NICOLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-01",
        "last_updated": "2020-10-01",
        "certification_date": "2020-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "FL",
            "license": "PS60283",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oviedo, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 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.

Verify at the official NPI Registry.