Anthony Paul Micolucci, RPH

Primary specialty

PharmacistTaxonomy code 183500000X

License

19929 Issued in FL

Practice address

2818 Madrid St
Jacksonville Beach, FL 32250-6066

Phone

(904) 945-0065

NPI assigned

Sep 19, 2022

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Pharmacist

State licenses

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

{
    "created_epoch": "1663545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663545600000",
    "number": "1841913555",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2818 MADRID ST",
            "city": "JACKSONVILLE BEACH",
            "state": "FL",
            "postal_code": "322506066",
            "telephone_number": "904-945-0065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2818 MADRID ST",
            "city": "JACKSONVILLE BEACH",
            "state": "FL",
            "postal_code": "322506066",
            "telephone_number": "904-945-0065"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MICOLUCCI",
        "first_name": "ANTHONY",
        "middle_name": "PAUL",
        "credential": "RPH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-09-19",
        "last_updated": "2022-09-19",
        "certification_date": "2022-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pharmacist",
            "state": "FL",
            "license": "19929",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Pharmacist in Jacksonville Beach, FL
• Providers in Jacksonville Beach, FL by specialty
• Pharmacist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2022; 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.