Active NPI
Dylan Lee Kio, PHARMD
- Pharmacist
- Middleburg, FL
National Provider Identifier
1891418521
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- P64474
- Practice address
- 2672 Blanding Blvd
Middleburg, FL 32068-9106 - Phone
- (904) 282-3828
- NPI assigned
- Sep 19, 2022
- Last updated
- Sep 19, 2022
- Sex
- Male
- Sole proprietor
- Yes
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 | P64474 | FL | Primary |
Addresses
Primary practice location
2672 Blanding Blvd
Middleburg, FL 32068-9106
Mailing address
2672 Blanding Blvd
Middleburg, FL 32068-9106
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
| License | State | Type | Specialty |
|---|---|---|---|
| P64474 | FL | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Holiday CVS L.L.C. | Past | Accepting new patients | |
| Holiday CVS LLC | 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": "1663545600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1663545600000",
"number": "1891418521",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2672 BLANDING BLVD",
"city": "MIDDLEBURG",
"state": "FL",
"postal_code": "320689106"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2672 BLANDING BLVD",
"city": "MIDDLEBURG",
"state": "FL",
"postal_code": "320689106",
"telephone_number": "904-282-3828"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIO",
"first_name": "DYLAN",
"middle_name": "LEE",
"credential": "PHARMD",
"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": "",
"desc": "Pharmacist",
"state": "FL",
"license": "P64474",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Middleburg, FL
Sources for this page
- 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.