Active NPI
Gwendolyn Haskell
- Pharmacist
- Miami Gardens, FL
National Provider Identifier
1528642949
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PS59136
- Practice address
- 19800 NW 2ND Ave
Miami Gardens, FL 33169-3342 - Phone
- (305) 493-5293
- NPI assigned
- May 11, 2021
- Last updated
- May 11, 2021
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | PS59136 | FL | Primary |
Addresses
Primary practice location
19800 NW 2ND Ave
Miami Gardens, FL 33169-3342
Mailing address
244 Three Islands Blvd Apt 303
Hallandale Beach, FL 33009-7329
Phone (954) 789-3565
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 |
|---|---|---|---|
| PS59136 | FL | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Holiday CVS LLC | Past | Accepting new patients | |
| Holiday CVS L.L.C. | Past | 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": "1620691200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1620691200000",
"number": "1528642949",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "244 THREE ISLANDS BLVD APT 303",
"city": "HALLANDALE BEACH",
"state": "FL",
"postal_code": "330097329",
"telephone_number": "954-789-3565"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "19800 NW 2ND AVE",
"city": "MIAMI GARDENS",
"state": "FL",
"postal_code": "331693342",
"telephone_number": "305-493-5293"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HASKELL",
"first_name": "GWENDOLYN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-05-11",
"last_updated": "2021-05-11",
"certification_date": "2021-05-11",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "FL",
"license": "PS59136",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Miami Gardens, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.