Active NPI
Sherin Ittiavirah
- Pharmacist
- Altamonte Springs, FL
National Provider Identifier
1437428711
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PS47283
- Practice address
- 1201 W State Road 436
Altamonte Springs, FL 32714-2736 - Phone
- (407) 389-7353
- NPI assigned
- Dec 15, 2011
- Last updated
- Dec 15, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | PS47283 | FL | Primary |
Addresses
Primary practice location
1201 W State Road 436
Altamonte Springs, FL 32714-2736
Mailing address
2315 Black Lake Blvd
Winter Garden, FL 34787-4756
Phone (407) 656-4547
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
| License | State | Type | Specialty |
|---|---|---|---|
| PS47283 | FL | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1323907200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1323907200000",
"number": "1437428711",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2315 BLACK LAKE BLVD",
"city": "WINTER GARDEN",
"state": "FL",
"postal_code": "347874756",
"telephone_number": "407-656-4547"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1201 W STATE ROAD 436",
"city": "ALTAMONTE SPRINGS",
"state": "FL",
"postal_code": "327142736",
"telephone_number": "407-389-7353"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ITTIAVIRAH",
"first_name": "SHERIN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-12-15",
"last_updated": "2011-12-15",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "FL",
"license": "PS47283",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Altamonte Springs, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 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.