Individual provider Active NPI

Latrice Roebuck, PHARM.D

  • Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
  • Hollywood, FL
National Provider Identifier
1841425923
Registry record updated Jul 15, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistTaxonomy code 1835P0018X
License
PS41695 Issued in FL
Practice address
2640 Hollywood Blvd
Suite 209
Hollywood, FL 33020-4852
Phone
(954) 367-3843
Fax
(954) 589-0083
NPI assigned
May 19, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 15, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist 1835P0018X PS41695 FL Primary
Pharmacotherapy Pharmacist 1835P1200X PS41695 FL

Addresses

Primary practice location

2640 Hollywood Blvd
Suite 209
Hollywood, FL 33020-4852

Mailing address

2640 Hollywood Blvd
Suite 209
Hollywood, FL 33020-4852
Phone (786) 210-0861

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
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
PS41695FLMDPharmacotherapy Pharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Pharmaceutical Care Associates Pharmacist Clinician (PHC)/ Clinical Pharmacy Specialist 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": "1242691200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1342310400000",
    "number": "1841425923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2640 HOLLYWOOD BLVD",
            "address_2": "SUITE 209",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330204852",
            "telephone_number": "786-210-0861"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2640 HOLLYWOOD BLVD",
            "address_2": "SUITE 209",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330204852",
            "telephone_number": "954-367-3843",
            "fax_number": "954-589-0083"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROEBUCK",
        "first_name": "LATRICE",
        "name_prefix": "Dr.",
        "credential": "PHARM.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-05-19",
        "last_updated": "2012-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "FL",
            "license": "PS41695",
            "primary": true
        },
        {
            "code": "1835P1200X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacotherapy",
            "state": "FL",
            "license": "PS41695",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hollywood, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2012; 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.