Individual provider Active NPI

Traci C Monroe, PHARMD

  • Pharmacist
  • Bay Pines, FL
National Provider Identifier
1437358579
Registry record updated Dec 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PS42341 Issued in FL
Practice address
10000 Bay Pines Blvd
Bay Pines, FL 33744-8200
Phone
(727) 398-6661
NPI assigned
Jul 17, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 18, 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 PS42341 FL Primary

Addresses

Primary practice location

10000 Bay Pines Blvd
Bay Pines, FL 33744-8200

Mailing address

10000 Bay Pines Blvd
Pharmacy Service (119)
Bay Pines, FL 33744

Other practice location 1

1601 SW Archer Rd
Pharmacy Service (119)
Gainesville, FL 32608-1135
Phone (352) 376-1611

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
PS42341FLMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1184630400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608249600000",
    "number": "1437358579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10000 BAY PINES BLVD",
            "address_2": "PHARMACY SERVICE (119)",
            "city": "BAY PINES",
            "state": "FL",
            "postal_code": "33744"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10000 BAY PINES BLVD",
            "city": "BAY PINES",
            "state": "FL",
            "postal_code": "337448200",
            "telephone_number": "727-398-6661"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1601 SW Archer Rd",
            "address_2": "Pharmacy Service (119)",
            "address_purpose": "LOCATION",
            "city": "Gainesville",
            "state": "FL",
            "postal_code": "326081135",
            "country_code": "US",
            "telephone_number": "352-376-1611",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MONROE",
        "first_name": "TRACI",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-17",
        "last_updated": "2020-12-18",
        "certification_date": "2020-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "FL",
            "license": "PS42341",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bay Pines, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 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.