Individual provider Active NPI

Michael Daniel Buttacavoli, RPH

  • Pharmacist
  • New Port Richey, FL
National Provider Identifier
1750461612
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
14445 Issued in FL
Practice address
4539 Grand Blvd
New Port Richey, FL 34652-5121
Phone
(727) 845-5550
Fax
(727) 848-3346
NPI assigned
Oct 16, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 14445 FL Primary

Addresses

Primary practice location

4539 Grand Blvd
New Port Richey, FL 34652-5121

Mailing address

8021 Moonlight LN
New Port Richey, FL 34654-5424
Phone (727) 841-8791

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
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
14445FLMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1160956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1750461612",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8021 MOONLIGHT LN",
            "city": "NEW PORT RICHEY",
            "state": "FL",
            "postal_code": "346545424",
            "telephone_number": "727-841-8791",
            "fax_number": "727-848-3346"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4539 GRAND BLVD",
            "city": "NEW PORT RICHEY",
            "state": "FL",
            "postal_code": "346525121",
            "telephone_number": "727-845-5550",
            "fax_number": "727-848-3346"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUTTACAVOLI",
        "first_name": "MICHAEL",
        "middle_name": "DANIEL",
        "credential": "RPH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "FL",
            "license": "14445",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Port Richey, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.