Active NPI
Susan McNeil Widziunas, RPH.
- Pharmacist
- Bradenton, FL
National Provider Identifier
1750482931
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PS36552
- Practice address
- 1010 53Rd Ave E
Bradenton, FL 34203-4804 - Phone
- (941) 727-2797
- Fax
- (941) 727-2792
- NPI assigned
- Sep 26, 2006
- Sex
- Female
- 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 | PS36552 | FL | Primary |
Addresses
Primary practice location
1010 53Rd Ave E
Bradenton, FL 34203-4804
Mailing address
14709 4TH Dr NE
Bradenton, FL 34212-5581
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PS36552 | Other | FL | STATE LICENSE |
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
| License | State | Type | Specialty |
|---|---|---|---|
| PS36552 | FL | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159228800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1750482931",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14709 4TH DR NE",
"city": "BRADENTON",
"state": "FL",
"postal_code": "342125581"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1010 53RD AVE E",
"city": "BRADENTON",
"state": "FL",
"postal_code": "342034804",
"telephone_number": "941-727-2797",
"fax_number": "941-727-2792"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WIDZIUNAS",
"first_name": "SUSAN",
"middle_name": "MCNEIL",
"credential": "RPH.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-09-26",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "FL",
"license": "PS36552",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENSE",
"identifier": "PS36552",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Bradenton, 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.