NPIMap

Individual provider Active NPI

Mario Kaller, RPH

  • Pharmacist
  • Coral Springs, FL
National Provider Identifier
1629316096
Registry record updated Jan 19, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PS19456 Issued in FL
Practice address
11600 W Sample Rd
Coral Springs, FL 33065-2650
Phone
(954) 509-5294
Fax
(954) 509-5299
NPI assigned
Jan 19, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PS19456 FL Primary

Addresses

Primary practice location

11600 W Sample Rd
Coral Springs, FL 33065-2650

Mailing address

11600 W Sample Rd
Coral Springs, FL 33065-2650
Phone (954) 509-5294

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
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
PS19456FLMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Publix Super Markets Inc Past Accepting new patients
Publix Super Markets Inc 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1358553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1358553600000",
    "number": "1629316096",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11600 W SAMPLE RD",
            "city": "CORAL SPRINGS",
            "state": "FL",
            "postal_code": "330652650",
            "telephone_number": "954-509-5294",
            "fax_number": "954-509-5299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11600 W SAMPLE RD",
            "city": "CORAL SPRINGS",
            "state": "FL",
            "postal_code": "330652650",
            "telephone_number": "954-509-5294",
            "fax_number": "954-509-5299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KALLER",
        "first_name": "MARIO",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-01-19",
        "last_updated": "2013-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "FL",
            "license": "PS19456",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coral Springs, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2013; 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.