Individual provider Active NPI

Michael Thiefault

  • Emergency Medicine Pharmacist
  • Pembroke Pines, FL
National Provider Identifier
1508779562
Registry record updated Sep 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PharmacistTaxonomy code 1835E0208X
License
PS64174 Issued in FL
Practice address
703 N Flamingo Rd
Pembroke Pines, FL 33028-1006
Phone
(954) 843-9000
NPI assigned
Sep 23, 2026
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 23, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Pharmacist 1835E0208X PS64174 FL Primary

Addresses

Primary practice location

703 N Flamingo Rd
Pembroke Pines, FL 33028-1006

Mailing address

4793 Via Bari Apt 7301
Lake Worth, FL 33463-6815
Phone (954) 843-9000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI Registry JSON

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

{
    "created_epoch": "1790121600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790121600000",
    "number": "1508779562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4793 VIA BARI APT 7301",
            "city": "LAKE WORTH",
            "state": "FL",
            "postal_code": "334636815",
            "telephone_number": "954-843-9000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "703 N FLAMINGO RD",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330281006",
            "telephone_number": "954-843-9000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THIEFAULT",
        "first_name": "MICHAEL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2026-09-23",
        "last_updated": "2026-09-23",
        "certification_date": "2026-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835E0208X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Emergency Medicine",
            "state": "FL",
            "license": "PS64174",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pembroke Pines, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.