Kevin Anthony Wiltz II, PHARMD

Primary specialty

PharmacistTaxonomy code 183500000X

License

PS38882 Issued in FL

Practice address

3200 Lake Emma Rd Unit 1000
Lake Mary, FL 32746-3358

Phone

(855) 733-3126

Fax

(407) 708-1834

NPI assigned

Jan 20, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

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

{
    "created_epoch": "1137715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1518048000000",
    "number": "1821078064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3200 LAKE EMMA RD UNIT 1000",
            "city": "LAKE MARY",
            "state": "FL",
            "postal_code": "327463358",
            "telephone_number": "855-733-3126",
            "fax_number": "407-708-1834"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3200 LAKE EMMA RD UNIT 1000",
            "city": "LAKE MARY",
            "state": "FL",
            "postal_code": "327463358",
            "telephone_number": "855-733-3126",
            "fax_number": "407-708-1834"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILTZ",
        "first_name": "KEVIN",
        "middle_name": "ANTHONY",
        "name_prefix": "Dr.",
        "name_suffix": "II",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-20",
        "last_updated": "2018-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "FL",
            "license": "PS38882",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "FL",
            "license": "PS38882",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "PS38882",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Pharmacist in Lake Mary, FL
• Providers in Lake Mary, FL by specialty
• Pharmacist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2018; 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.