North Fort Myers Prescription Shop, Inc.

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PH25927 Issued in FL

Legal business name

NORTH FORT MYERS PRESCRIPTION SHOP, INC.

Doing business as

North Fort Myers Prescription Shop

Practice address

16251 N Cleveland Ave
Suite 13
North Fort Myers, FL 33903-2176

Phone

(239) 599-4120

Fax

(239) 599-4122

NPI assigned

Feb 11, 2012

Organization subpart

No

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

Authorized official

Name

Lisa Lawrence, PHARMDNPI 1891935920

Title

Owner/Pharmacist in Charge

Phone

(239) 599-4120

Specialties & licenses 3

Addresses

Other identifiers 2

Other names 1

• North Fort Myers Prescription Shop Doing business as

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Lisa Marie Lawrence, PHARMD

  • Pharmacist
  • North Fort Myers, FL
  • NPI 1891935920
  NPD Authorized official

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

{
    "created_epoch": "1328918400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1487203200000",
    "number": "1700159498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16251 N CLEVELAND AVE",
            "address_2": "SUITE 13",
            "city": "NORTH FORT MYERS",
            "state": "FL",
            "postal_code": "339032176",
            "telephone_number": "239-599-4120",
            "fax_number": "239-599-4122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16251 N CLEVELAND AVE",
            "address_2": "SUITE 13",
            "city": "NORTH FORT MYERS",
            "state": "FL",
            "postal_code": "339032176",
            "telephone_number": "239-599-4120",
            "fax_number": "239-599-4122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH FORT MYERS PRESCRIPTION SHOP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-02-11",
        "last_updated": "2017-02-16",
        "status": "A",
        "authorized_official_last_name": "LAWRENCE",
        "authorized_official_first_name": "LISA",
        "authorized_official_title_or_position": "OWNER/PHARMACIST IN CHARGE",
        "authorized_official_telephone_number": "239-599-4120",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "FL",
            "license": "PH25927",
            "primary": true
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2133999",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004617200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "North Fort Myers Prescription Shop",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kenna Madison Nielsen, DPT
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• North Fort Myers Facility Operations, LLC (Raydiant Health Care of North Fort Myers)
• Hugo Jose Ocando Tuvinez
• Ocean Bloom ABA Center LLC
• Lauren Ohly, LCSW
• Lazaro Daniel Oliva Hernandez
• Claudia Ornacki

• Community/Retail Pharmacy in North Fort Myers, FL
• Providers in North Fort Myers, FL by specialty
• Community/Retail Pharmacy in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 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.