Active NPI
David Hasebroock, PHARMACIST
- Pharmacist
- Lakeland, FL
National Provider Identifier
1750035473
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 23133
- Practice address
- 2223 Blue Highlands Dr
Lakeland, FL 33811-2840 - Phone
- (813) 203-4783
- NPI assigned
- Feb 10, 2022
- Last updated
- Feb 10, 2022
- 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 | 23133 | FL | Primary |
Addresses
Primary practice location
2223 Blue Highlands Dr
Lakeland, FL 33811-2840
Mailing address
2223 Blue Highlands Dr
Lakeland, FL 33811-2840
Phone (813) 203-4783
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 23133 | Other | FL | FLORIDA DEPART OF HEALTH |
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 |
|---|---|---|---|
| 23133 | FL | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1644451200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1644451200000",
"number": "1750035473",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2223 BLUE HIGHLANDS DR",
"city": "LAKELAND",
"state": "FL",
"postal_code": "338112840",
"telephone_number": "813-203-4783"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2223 BLUE HIGHLANDS DR",
"city": "LAKELAND",
"state": "FL",
"postal_code": "338112840",
"telephone_number": "813-203-4783"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HASEBROOCK",
"first_name": "DAVID",
"credential": "PHARMACIST",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2022-02-10",
"last_updated": "2022-02-10",
"certification_date": "2022-02-10",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "FL",
"license": "23133",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FLORIDA DEPART OF HEALTH",
"identifier": "23133",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lakeland, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.