Individual provider Active NPI

Sudha Ranga Naga Koganti

  • Pharmacist
  • Miramar, FL
National Provider Identifier
1811264138
Registry record updated Dec 1, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PS38384 Issued in FL
Practice address
19279 SW 54TH St
Miramar, FL 33029-6269
Phone
(305) 975-8712
NPI assigned
Dec 1, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 1, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PS38384 FL Primary

Addresses

Primary practice location

19279 SW 54TH St
Miramar, FL 33029-6269

Mailing address

19279 SW 54TH St
Miramar, FL 33029-6269
Phone (305) 975-8712

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

State licenses

LicenseStateTypeSpecialty
PS38384FLMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1322697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1322697600000",
    "number": "1811264138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19279 SW 54TH ST",
            "city": "MIRAMAR",
            "state": "FL",
            "postal_code": "330296269",
            "telephone_number": "305-975-8712"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19279 SW 54TH ST",
            "city": "MIRAMAR",
            "state": "FL",
            "postal_code": "330296269",
            "telephone_number": "305-975-8712"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOGANTI",
        "first_name": "SUDHA",
        "middle_name": "RANGA NAGA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-12-01",
        "last_updated": "2011-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "FL",
            "license": "PS38384",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miramar, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2011; 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.