Active NPI
Jeremy Liu
- Pharmacy
- Orlando, FL
National Provider Identifier
1508429440
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacy
- License
- 28RI03988200
- Practice address
- 13800 Veterans Way
Orlando, FL 32827-7401 - Phone
- (732) 853-9584
- NPI assigned
- Apr 16, 2019
- 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 |
|---|---|---|---|---|
| Pharmacy | 333600000X | 28RI03988200 | NJ | Primary |
Addresses
Primary practice location
13800 Veterans Way
Orlando, FL 32827-7401
Mailing address
26 Village Rd
Kendall Park, NJ 08824-1546
Phone (732) 940-6606
Other practice location 1
11301 Wilshire Blvd
Los Angeles, CA 90073
Phone (732) 853-9584
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 |
|---|---|---|---|
| 28RI03988200 | NJ | MD | Pharmacy |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1555372800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1598918400000",
"number": "1508429440",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "26 VILLAGE RD",
"city": "KENDALL PARK",
"state": "NJ",
"postal_code": "088241546",
"telephone_number": "732-940-6606"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13800 VETERANS WAY",
"city": "ORLANDO",
"state": "FL",
"postal_code": "328277401",
"telephone_number": "732-853-9584"
}
],
"practiceLocations": [
{
"address_1": "11301 Wilshire Blvd",
"address_purpose": "LOCATION",
"city": "Los Angeles",
"state": "CA",
"postal_code": "90073",
"country_code": "US",
"telephone_number": "732-853-9584",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "LIU",
"first_name": "JEREMY",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2019-04-16",
"last_updated": "2020-09-01",
"certification_date": "2020-09-01",
"status": "A"
},
"taxonomies": [
{
"code": "333600000X",
"taxonomy_group": "",
"desc": "Pharmacy",
"state": "NJ",
"license": "28RI03988200",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Orlando, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.