Active NPI
Krystel Gomez
- Pharmacist
- Davie, FL
National Provider Identifier
1881314763
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PS64740
- Practice address
- 3015 S University Dr
Davie, FL 33328-2013 - Phone
- (954) 475-9222
- Fax
- (954) 475-1240
- NPI assigned
- Aug 31, 2022
- Last updated
- Aug 31, 2022
- 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 | PS64740 | FL | Primary |
Addresses
Primary practice location
3015 S University Dr
Davie, FL 33328-2013
Mailing address
3015 S University Dr
Davie, FL 33328-2013
Phone (954) 475-9222
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 |
|---|---|---|---|
| PS64740 | FL | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1661904000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1661904000000",
"number": "1881314763",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3015 S UNIVERSITY DR",
"city": "DAVIE",
"state": "FL",
"postal_code": "333282013",
"telephone_number": "954-475-9222",
"fax_number": "954-475-1240"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3015 S UNIVERSITY DR",
"city": "DAVIE",
"state": "FL",
"postal_code": "333282013",
"telephone_number": "954-475-9222",
"fax_number": "954-475-1240"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOMEZ",
"first_name": "KRYSTEL",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-08-31",
"last_updated": "2022-08-31",
"certification_date": "2022-08-30",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "FL",
"license": "PS64740",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Davie, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 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.