Active NPI
Edward Cereceda Gutierrez
- Pharmacist
- Dunedin, FL
National Provider Identifier
1447521166
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PS19137
- Practice address
- 1477 Main St
Dunedin, FL 34698-6243 - Phone
- (727) 733-3176
- NPI assigned
- Jan 26, 2012
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | PS19137 | FL | Primary |
Addresses
Primary practice location
1477 Main St
Dunedin, FL 34698-6243
Mailing address
2712 Montague CT E
Clearwater, FL 33761-1217
Phone (727) 772-9089
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 |
|---|---|---|---|
| PS19137 | FL | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1327536000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1327536000000",
"number": "1447521166",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2712 MONTAGUE CT E",
"city": "CLEARWATER",
"state": "FL",
"postal_code": "337611217",
"telephone_number": "727-772-9089"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1477 MAIN ST",
"city": "DUNEDIN",
"state": "FL",
"postal_code": "346986243",
"telephone_number": "727-733-3176"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GUTIERREZ",
"first_name": "EDWARD",
"middle_name": "CERECEDA",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2012-01-26",
"last_updated": "2012-01-26",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "FL",
"license": "PS19137",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dunedin, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 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.