Active NPI
Diane L Elis, RPH
- Pharmacist
- Tampa, FL
National Provider Identifier
1437429172
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PS31971
- Practice address
- 15602 N Dale Mabry Hwy
Tampa, FL 33618-1606 - Phone
- (813) 264-7722
- Fax
- (813) 963-5823
- NPI assigned
- Jan 11, 2012
- Last updated
- Jan 11, 2012
- 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 | PS31971 | FL | Primary |
Addresses
Primary practice location
15602 N Dale Mabry Hwy
Tampa, FL 33618-1606
Mailing address
12359 Witheridge Dr
Tampa, FL 33624-5728
Phone (813) 968-3334
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 |
|---|---|---|---|
| PS31971 | FL | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1326240000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1326240000000",
"number": "1437429172",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12359 WITHERIDGE DR",
"city": "TAMPA",
"state": "FL",
"postal_code": "336245728",
"telephone_number": "813-968-3334"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15602 N DALE MABRY HWY",
"city": "TAMPA",
"state": "FL",
"postal_code": "336181606",
"telephone_number": "813-264-7722",
"fax_number": "813-963-5823"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ELIS",
"first_name": "DIANE",
"middle_name": "L",
"name_prefix": "Ms.",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-01-11",
"last_updated": "2012-01-11",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "FL",
"license": "PS31971",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.