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
- 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 L.L.C. | Past | Accepting new patients | |
| Holiday CVS LLC | 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.
-
- Pharmacy
- Wesley Chapel, FL
- NPI 1770467466
-
- Pharmacy
- Miami, FL
- NPI 1174627087
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.