Guardian Pharmacy of Southeast Florida LLC

Primary specialty

Long Term Care PharmacyTaxonomy code 3336L0003X

License

PH22966 Issued in FL

Legal business name

GUARDIAN PHARMACY OF SOUTHEAST FLORIDA LLC

Practice address

6100 Broken Sound Pkwy NW Ste 1
Boca Raton, FL 33487-2790

Phone

(954) 601-2121

Fax

(954) 601-2400

NPI assigned

Dec 14, 2006

Organization subpart

No

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

Authorized official

Name

Alan Traster

Title

President

Phone

(954) 601-2121

Specialties & licenses 4

Addresses

Other identifiers 2

Other names 1

• Guardian Pharmacy of Southeast Florida Doing business as

Medicare fee-for-service enrollment

Enrolled in FL2 enrollments

Enrollment records 2

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Medicare medical equipment & supply locations

Member organizations 2

Organizations listed as members of this organization in the National Provider Directory.

• Guardian Pharmacy of Southwest Florida LLC

  • Long Term Care Pharmacy
  • Naples, FL
  • NPI 1154147015

  Member Of

  NPD member
• Guardian Pharmacy of Southwest Florida LLC

  • Long Term Care Pharmacy
  • North Port, FL
  • NPI 1285024125

  Member Of

  NPD member

Locations

Networks

• Freedom Health HMO NetworkPlans: Freedom Platinum Rewards Plan Rx (HMO) (H5427-102-000, H5427); Freedom VIP Care (HMO C-SNP) (H5427-070-000, H5427); Freedom VIP Rewards (HMO C-SNP) (H5427-108-000, H5427); Freedom VIP Rewards (HMO C-SNP) (H5427-099-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-107-000, H5427); Freedom Maximo (HMO-POS) (H5427-113-000, H5427); Freedom Savings Plan (HMO) (H5427-052-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-096-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-105-000, H5427); Freedom Medi-Medi Full (HMO D-SNP) (H5427-087-000, H5427)…
• HealthSun Health Plans Network
• Optimum HealthCare HMO NetworkPlans: Optimum Diamond Rewards (HMO C-SNP) (H5594-028-000, H5594); Optimum Diamond (HMO C-SNP) (H5594-036-000, H5594); Optimum Diamond Rewards (HMO C-SNP) (H5594-034-000, H5594); Optimum Diamond Rewards COPD (HMO C-SNP) (H5594-029-000, H5594); Optimum Platinum Plan (HMO) (H5594-002-000, H5594); Optimum Gold Plus Plan (HMO) (H5594-032-000, H5594); Optimum Diamond Savings COPD (HMO C-SNP) (H5594-031-000, H5594); Optimum Diamond Savings (HMO C-SNP) (H5594-030-000, H5594); Optimum Diamond Rewards COPD (HMO C-SNP) (H5594-035-000, H5594)

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

{
    "created_epoch": "1166054400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1591833600000",
    "number": "1851453468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "GUARDIAN PHARMACY OF SOUTHEAST FLORIDA DEPT 2355",
            "address_2": "P.O. BOX 11407",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352460001",
            "telephone_number": "404-810-0089",
            "fax_number": "404-810-0094"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6100 BROKEN SOUND PKWY NW STE 1",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334872790",
            "telephone_number": "954-601-2121",
            "fax_number": "954-601-2400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GUARDIAN PHARMACY OF SOUTHEAST FLORIDA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-14",
        "last_updated": "2020-06-11",
        "certification_date": "2020-06-11",
        "status": "A",
        "authorized_official_last_name": "TRASTER",
        "authorized_official_first_name": "ALAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "954-601-2121"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "FL",
            "license": "PH22966",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2004166",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "032158300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Guardian Pharmacy of Southeast Florida",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Guardian Pharmacy of Southeast Florida",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• GTV Networks, Inc.
• Guardian Care of Palm Beach
• Guardian Companionship & Care LLC
• Guardian Diagnostics LLC
• Guardian DME LLC
• Guardian Recovery Boca Raton Adolescent Center, LLC
• Vito Joseph Guario, OD
• Svetlana Gudenko
• Daisy Beatriz Guerrero de Quer
• Faustina Guerrero

• Long Term Care Pharmacy in Boca Raton, FL
• Providers in Boca Raton, FL by specialty
• Long Term Care Pharmacy in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.