Active NPI
Mirjana Tasic-Pantic, RPH, CPH
- Pharmacist
- Delray Beach, FL
National Provider Identifier
1790374171
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PS38383
- Practice address
- 4900 Linton Blvd Ste 24
Delray Beach, FL 33445-6687 - Phone
- (561) 921-2025
- NPI assigned
- Jan 11, 2021
- Sex
- Female
- 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 | PS38383 | FL | Primary |
Addresses
Primary practice location
4900 Linton Blvd Ste 24
Delray Beach, FL 33445-6687
Mailing address
6267 Barton Creek Cir
Lake Worth, FL 33463-6544
Phone (561) 951-0824
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 |
|---|---|---|---|
| PS38383 | FL | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sofko LLC | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1610323200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1610323200000",
"number": "1790374171",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6267 BARTON CREEK CIR",
"city": "LAKE WORTH",
"state": "FL",
"postal_code": "334636544",
"telephone_number": "561-951-0824"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4900 LINTON BLVD STE 24",
"city": "DELRAY BEACH",
"state": "FL",
"postal_code": "334456687",
"telephone_number": "561-921-2025"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TASIC-PANTIC",
"first_name": "MIRJANA",
"credential": "RPH, CPH",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-01-11",
"last_updated": "2021-01-11",
"certification_date": "2021-01-11",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "FL",
"license": "PS38383",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Delray Beach, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.