Individual provider Active NPI

Carmen P Agboton, PHARMD

  • Pharmacist
  • Tallahassee, FL
National Provider Identifier
1790030112
Registry record updated Jul 23, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PS48128 Issued in FL
Practice address
2634 Capital Cir NE
Tallahassee, FL 32308-4106
Phone
(850) 523-3348
NPI assigned
Jul 23, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PS48128 FL Primary
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist 1835P0018X PS48128 FL

Addresses

Primary practice location

2634 Capital Cir NE
Tallahassee, FL 32308-4106

Mailing address

501 Blairstone Rd Apt 2621
Tallahassee, FL 32301-3042
Phone (305) 282-5918

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

LicenseStateTypeSpecialty
PS48128FLMDPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist

NPI Registry JSON

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

{
    "created_epoch": "1343001600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1343001600000",
    "number": "1790030112",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 BLAIRSTONE RD APT 2621",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323013042",
            "telephone_number": "305-282-5918"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2634 CAPITAL CIR NE",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323084106",
            "telephone_number": "850-523-3348"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AGBOTON",
        "first_name": "CARMEN",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-23",
        "last_updated": "2012-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "FL",
            "license": "PS48128",
            "primary": true
        },
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "FL",
            "license": "PS48128",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tallahassee, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2012; 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.