Individual provider Active NPI

Jessica Vaval

  • Pharmacist
  • Hollywood, FL
National Provider Identifier
1740698448
Registry record updated Jul 25, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PS52185 Issued in FL
Practice address
300 Hollywood Mall
Hollywood, FL 33021-6904
Phone
(954) 962-5373
NPI assigned
Jul 25, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 25, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PS52185 FL Primary

Addresses

Primary practice location

300 Hollywood Mall
Hollywood, FL 33021-6904

Mailing address

4827 NW 22ND PL
Coconut Creek, FL 33063-7761
Phone (954) 655-7012

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

LicenseStateTypeSpecialty
PS52185FLMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1406246400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1406246400000",
    "number": "1740698448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4827 NW 22ND PL",
            "city": "COCONUT CREEK",
            "state": "FL",
            "postal_code": "330637761",
            "telephone_number": "954-655-7012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 HOLLYWOOD MALL",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330216904",
            "telephone_number": "954-962-5373"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAVAL",
        "first_name": "JESSICA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-07-25",
        "last_updated": "2014-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "FL",
            "license": "PS52185",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hollywood, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 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.

Verify at the official NPI Registry.