Individual provider Active NPI

Michael Blake Aldridge, RPH

  • Pharmacist
  • Palm Bay, FL
National Provider Identifier
1790886166
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PS37762 Issued in FL
Practice address
5270 Babcock St NE Ste 120
Palm Bay, FL 32905-8630
Phone
(321) 728-7041
Fax
(321) 728-5822
NPI assigned
Sep 26, 2006
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 PS37762 FL Primary

Addresses

Primary practice location

5270 Babcock St NE Ste 120
Palm Bay, FL 32905-8630

Mailing address

234 Brandy Creek Cir SE
Palm Bay, FL 32909-2332
Phone (321) 953-4792

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
PS37762FLMDPharmacist

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": "1790886166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "234 BRANDY CREEK CIR SE",
            "city": "PALM BAY",
            "state": "FL",
            "postal_code": "329092332",
            "telephone_number": "321-953-4792"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5270 BABCOCK ST NE STE 120",
            "city": "PALM BAY",
            "state": "FL",
            "postal_code": "329058630",
            "telephone_number": "321-728-7041",
            "fax_number": "321-728-5822"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALDRIDGE",
        "first_name": "MICHAEL",
        "middle_name": "BLAKE",
        "name_prefix": "Mr.",
        "credential": "RPH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "FL",
            "license": "PS37762",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Bay, 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.