Active NPI
Nicole Derisma
- Pharmacist
- Weston, FL
National Provider Identifier
1831565134
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PS53975
- Practice address
- 199 Weston Rd
Attn: Walgreens #6403
Weston, FL 33326-1143 - Phone
- (954) 384-0011
- NPI assigned
- Aug 20, 2015
- Sex
- Female
- Sole proprietor
- No
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 | PS53975 | FL | Primary |
Addresses
Primary practice location
199 Weston Rd
Attn: Walgreens #6403
Weston, FL 33326-1143
Mailing address
199 Weston Rd
Attn: Walgreens #6403
Weston, FL 33326-1143
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
| License | State | Type | Specialty |
|---|---|---|---|
| PS53975 | FL | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1440028800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1440028800000",
"number": "1831565134",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "199 WESTON RD",
"address_2": "ATTN: WALGREENS #6403",
"city": "WESTON",
"state": "FL",
"postal_code": "333261143"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "199 WESTON RD",
"address_2": "ATTN: WALGREENS #6403",
"city": "WESTON",
"state": "FL",
"postal_code": "333261143",
"telephone_number": "954-384-0011"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DERISMA",
"first_name": "NICOLE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-08-20",
"last_updated": "2015-08-20",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "FL",
"license": "PS53975",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Weston, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.