Active NPI
Jack Rose, PHARMD
- Pharmacist
- Orlando, FL
National Provider Identifier
1710382700
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PS52731
- Practice address
- 7650 W Sand Lake Rd
Orlando, FL 32819-5112 - Phone
- (407) 370-6742
- NPI assigned
- Nov 3, 2014
- Last updated
- Nov 3, 2014
- 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 | PS52731 | FL | Primary |
Addresses
Primary practice location
7650 W Sand Lake Rd
Orlando, FL 32819-5112
Mailing address
16407 Nelson Park Dr Apt 106
Clermont, FL 34714-5845
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 |
|---|---|---|---|
| PS52731 | FL | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | 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": "1414972800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1414972800000",
"number": "1710382700",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16407 NELSON PARK DR APT 106",
"city": "CLERMONT",
"state": "FL",
"postal_code": "347145845"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7650 W SAND LAKE RD",
"city": "ORLANDO",
"state": "FL",
"postal_code": "328195112",
"telephone_number": "407-370-6742"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROSE",
"first_name": "JACK",
"name_prefix": "Dr.",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-11-03",
"last_updated": "2014-11-03",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "FL",
"license": "PS52731",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Orlando, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.