Individual provider Active NPI

Harry P Marcelin, PHARMD

  • Pharmacist
  • Lauderdale Lakes, FL
National Provider Identifier
1457056061
Registry record updated Apr 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PS47012 Issued in FL
Practice address
4010 NW 34TH St
Lauderdale Lakes, FL 33319-5721
Phone
(954) 486-7101
NPI assigned
Apr 3, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 3, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PS47012 FL Primary
Pharmacist 183500000X 19627 NC

Addresses

Primary practice location

4010 NW 34TH St
Lauderdale Lakes, FL 33319-5721

Mailing address

4010 NW 34TH St
Lauderdale Lakes, FL 33319-5721
Phone (954) 486-7101

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
PS47012FLMDPharmacist
19627NCMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Ladonna Dahl,Psy.D., Inc. Current Accepting new patients
St Croix Medical Group, Inc. Current Accepting new patients
St Croix Medical Pharmacy Current Accepting new patients

Locations

4010 NW 34th St
Lauderdale Lakes, FL 33319
Phone (919) 360-0853

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1680480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680480000000",
    "number": "1457056061",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4010 NW 34TH ST",
            "city": "LAUDERDALE LAKES",
            "state": "FL",
            "postal_code": "333195721",
            "telephone_number": "954-486-7101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4010 NW 34TH ST",
            "city": "LAUDERDALE LAKES",
            "state": "FL",
            "postal_code": "333195721",
            "telephone_number": "954-486-7101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARCELIN",
        "first_name": "HARRY",
        "middle_name": "P",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-04-03",
        "last_updated": "2023-04-03",
        "certification_date": "2023-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "FL",
            "license": "PS47012",
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NC",
            "license": "19627",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lauderdale Lakes, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2023; 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.