NPIMap

Individual provider Active NPI

Krunal Bhagat

  • Pharmacist
  • Fort Myers, FL
National Provider Identifier
1841893567
Registry record updated Nov 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PS47390 Issued in FL
Practice address
2403 Cleveland Ave
Fort Myers, FL 33901-4904
Phone
(239) 332-3050
NPI assigned
Nov 17, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PS47390 FL Primary

Addresses

Primary practice location

2403 Cleveland Ave
Fort Myers, FL 33901-4904

Mailing address

9368 River Otter Dr
Fort Myers, FL 33912-8924
Phone (954) 980-4925

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
PS47390FLMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Pelican Village Pharmacy, LLC Current Accepting new patients
Holiday CVS L.L.C. PastSince Nov 22, 2020 Accepting new patients
Holiday CVS LLC PastSince Nov 22, 2020 Accepting new patients

Organizations & group practices 3

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": "1605571200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605571200000",
    "number": "1841893567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9368 RIVER OTTER DR",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339128924",
            "telephone_number": "954-980-4925"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2403 CLEVELAND AVE",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339014904",
            "telephone_number": "239-332-3050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BHAGAT",
        "first_name": "KRUNAL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-11-17",
        "last_updated": "2020-11-17",
        "certification_date": "2020-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "FL",
            "license": "PS47390",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Myers, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2020; 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.