Active NPI
Jessica Flores
- Pharmacist
- Fort Walton Beach, FL
National Provider Identifier
1588376214
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PS65195
- Practice address
- 434 Racetrack Rd NE
Fort Walton Beach, FL 32547-3924 - Phone
- (850) 315-0474
- NPI assigned
- Dec 14, 2022
- Last updated
- Dec 14, 2022
- 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 | PS65195 | FL | Primary |
Addresses
Primary practice location
434 Racetrack Rd NE
Fort Walton Beach, FL 32547-3924
Mailing address
636 Acha Dr
Hurlburt Field, FL 32544-1093
Phone (305) 490-2441
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 |
|---|---|---|---|
| PS65195 | 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": "1670976000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1670976000000",
"number": "1588376214",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "636 ACHA DR",
"city": "HURLBURT FIELD",
"state": "FL",
"postal_code": "325441093",
"telephone_number": "305-490-2441"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "434 RACETRACK RD NE",
"city": "FORT WALTON BEACH",
"state": "FL",
"postal_code": "325473924",
"telephone_number": "850-315-0474"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FLORES",
"first_name": "JESSICA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-12-14",
"last_updated": "2022-12-14",
"certification_date": "2022-12-13",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "FL",
"license": "PS65195",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Walton Beach, FL
- FKP Fort Walton Beach Senior Living Tenant LLC (Belvedere Commons of Fort Walton Beach)
- FL-I Medical Services LLC
- Laura M. Flaherty, PT
- Leslie R Fleischer, M.D.
- Jamie Marie Flink, CRNA
- Florida Department of Health (Okaloosa County Health Dept-FFS)
- Florida Department of Health (Okaloosa Co. Health Dept)
- Florida Department of Health (Okaloosa County Health Dept-Ryan White)
- Florida Department of Health (Okaloosa County Health Dept-School Health)
- Florida Department of Health (Okaloosa County Health Dept-STD)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.