Individual provider Active NPI

Antonella Lezark, PHARM.D

  • Pharmacist
  • Hialeah, FL
National Provider Identifier
1619578739
Registry record updated Nov 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PS54050 Issued in FL
Practice address
5851 NW 177TH St
Hialeah, FL 33015-5127
Phone
(305) 558-7490
NPI assigned
Nov 4, 2020
Last updated
Nov 4, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 4, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PS54050 FL Primary

Addresses

Primary practice location

5851 NW 177TH St
Hialeah, FL 33015-5127

Mailing address

5851 NW 177TH St
Hialeah, FL 33015-5127
Phone (305) 558-7490

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
PS54050FLMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1604448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604448000000",
    "number": "1619578739",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5851 NW 177TH ST",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330155127",
            "telephone_number": "305-558-7490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5851 NW 177TH ST",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330155127",
            "telephone_number": "305-558-7490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEZARK",
        "first_name": "ANTONELLA",
        "name_prefix": "Dr.",
        "credential": "PHARM.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-11-04",
        "last_updated": "2020-11-04",
        "certification_date": "2020-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "FL",
            "license": "PS54050",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hialeah, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 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.

Verify at the official NPI Registry.