Active NPI
Michael W Fernstrum
- Pharmacist
- Clearwater, FL
National Provider Identifier
1457892234
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PS 32916
- Practice address
- 2655 Gulf to Bay Blvd
Clearwater, FL 33759-4936 - Phone
- (727) 373-1953
- NPI assigned
- Mar 14, 2017
- Last updated
- Mar 14, 2017
- Sex
- Male
- 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 | PS 32916 | FL | Primary |
Addresses
Primary practice location
2655 Gulf to Bay Blvd
Clearwater, FL 33759-4936
Mailing address
583 E Park Dr
Largo, FL 33771-1337
Phone (813) 789-5920
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 |
|---|---|---|---|
| PS 32916 | FL | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1489449600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1489449600000",
"number": "1457892234",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "583 E PARK DR",
"city": "LARGO",
"state": "FL",
"postal_code": "337711337",
"telephone_number": "813-789-5920"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2655 GULF TO BAY BLVD",
"city": "CLEARWATER",
"state": "FL",
"postal_code": "337594936",
"telephone_number": "727-373-1953"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FERNSTRUM",
"first_name": "MICHAEL",
"middle_name": "W",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-03-14",
"last_updated": "2017-03-14",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "FL",
"license": "PS 32916",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Clearwater, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.