Active NPI
Antonio Miguel De Leon
- Pharmacist
- Miami, FL
National Provider Identifier
1629670542
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PS53625
- Practice address
- 650 NW 27TH Ave
Miami, FL 33125-3037 - Phone
- (305) 631-0874
- NPI assigned
- Nov 16, 2020
- Last updated
- Nov 16, 2020
- Sex
- Male
- 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 | PS53625 | FL | Primary |
Addresses
Primary practice location
650 NW 27TH Ave
Miami, FL 33125-3037
Mailing address
7170 SW 7TH St
Miami, FL 33144-2741
Phone (786) 543-5967
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 |
|---|---|---|---|
| PS53625 | 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": "1605484800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1605484800000",
"number": "1629670542",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7170 SW 7TH ST",
"city": "MIAMI",
"state": "FL",
"postal_code": "331442741",
"telephone_number": "786-543-5967"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "650 NW 27TH AVE",
"city": "MIAMI",
"state": "FL",
"postal_code": "331253037",
"telephone_number": "305-631-0874"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DE LEON",
"first_name": "ANTONIO",
"middle_name": "MIGUEL",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2020-11-16",
"last_updated": "2020-11-16",
"certification_date": "2020-11-16",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "FL",
"license": "PS53625",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Miami, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 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.