Individual provider Active NPI

Aiste Sudmantaite

  • Pharmacist
  • Fort Myers, FL
National Provider Identifier
1629583422
Registry record updated Dec 4, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PS57327 Issued in FL
Practice address
13650 Fiddlesticks Blvd
Fort Myers, FL 33912-0312
Phone
(239) 768-1413
NPI assigned
Dec 4, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PS57327 FL Primary

Addresses

Primary practice location

13650 Fiddlesticks Blvd
Fort Myers, FL 33912-0312

Mailing address

13650 Fiddlesticks Blvd
Fort Myers, FL 33912-0312

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

LicenseStateTypeSpecialty
PS57327FLMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1512345600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1512345600000",
    "number": "1629583422",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13650 FIDDLESTICKS BLVD",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339120312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13650 FIDDLESTICKS BLVD",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339120312",
            "telephone_number": "239-768-1413"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUDMANTAITE",
        "first_name": "AISTE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-12-04",
        "last_updated": "2017-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "FL",
            "license": "PS57327",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Myers, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2017; 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.