Active NPI
Robert Tzimun Chan, PHARMD
- Pharmacist
- Fort Myers, FL
National Provider Identifier
1679177745
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PS55893
- Practice address
- 16950 Pine Ridge Rd
Fort Myers, FL 33908-4050 - Phone
- (239) 466-3000
- Fax
- (239) 466-2734
- NPI assigned
- Nov 29, 2020
- Last updated
- Nov 29, 2020
- Sex
- Male
- Sole proprietor
- No
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 | PS55893 | FL | Primary |
Addresses
Primary practice location
16950 Pine Ridge Rd
Fort Myers, FL 33908-4050
Mailing address
16950 Pine Ridge Rd
Fort Myers, FL 33908-4050
Phone (239) 466-3000
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
| License | State | Type | Specialty |
|---|---|---|---|
| PS55893 | 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, 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": "1606608000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1606608000000",
"number": "1679177745",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16950 PINE RIDGE RD",
"city": "FORT MYERS",
"state": "FL",
"postal_code": "339084050",
"telephone_number": "239-466-3000",
"fax_number": "239-466-2734"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16950 PINE RIDGE RD",
"city": "FORT MYERS",
"state": "FL",
"postal_code": "339084050",
"telephone_number": "239-466-3000",
"fax_number": "239-466-2734"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHAN",
"first_name": "ROBERT",
"middle_name": "TZIMUN",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-11-29",
"last_updated": "2020-11-29",
"certification_date": "2020-11-29",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "FL",
"license": "PS55893",
"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 Nov 29, 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.