Individual provider Active NPI

Latrevia Spencer Igbokwe, PHARMD

  • Pharmacist
  • Lake Mary, FL
National Provider Identifier
1508400789
Registry record updated May 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PS40538 Issued in FL
Practice address
100 Technology Park Ste 158
Lake Mary, FL 32746-6205
Phone
(407) 618-3611
NPI assigned
Oct 31, 2019
Last updated
May 13, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PS40538 FL Primary

Addresses

Primary practice location

100 Technology Park Ste 158
Lake Mary, FL 32746-6205

Mailing address

100 Technology Park Ste 158
Lake Mary, FL 32746-6205
Phone (407) 618-3611

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
PS40538FLMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Wal-Mart Stores East LP PastSince Nov 3, 2019 Accepting new patients
Wal-Mart Stores East, LP PastSince Nov 3, 2019 Accepting new patients

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1572480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778630400000",
    "number": "1508400789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 TECHNOLOGY PARK STE 158",
            "city": "LAKE MARY",
            "state": "FL",
            "postal_code": "327466205",
            "telephone_number": "407-618-3611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 TECHNOLOGY PARK STE 158",
            "city": "LAKE MARY",
            "state": "FL",
            "postal_code": "327466205",
            "telephone_number": "407-618-3611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPENCER IGBOKWE",
        "first_name": "LATREVIA",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-31",
        "last_updated": "2026-05-13",
        "certification_date": "2026-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "FL",
            "license": "PS40538",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Mary, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2026; 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.