Active NPI
Keith Alan Holley
- Pharmacist
- Riverview, FL
National Provider Identifier
1922377605
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PS019151
- Practice address
- 11010 Bloomingdale Ave
Riverview, FL 33578-3617 - Phone
- (813) 661-5222
- NPI assigned
- Dec 23, 2011
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | PS019151 | FL | Primary |
| Pharmacist | 183500000X | 10305 | AL |
Addresses
Primary practice location
11010 Bloomingdale Ave
Riverview, FL 33578-3617
Mailing address
5503 Winding Brook LN
Valrico, FL 33596-7959
Phone (813) 681-4170
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 |
|---|---|---|---|
| 10305 | AL | MD | Pharmacist |
| PS019151 | FL | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1324598400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1324598400000",
"number": "1922377605",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5503 WINDING BROOK LN",
"city": "VALRICO",
"state": "FL",
"postal_code": "335967959",
"telephone_number": "813-681-4170"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11010 BLOOMINGDALE AVE",
"city": "RIVERVIEW",
"state": "FL",
"postal_code": "335783617",
"telephone_number": "813-661-5222"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOLLEY",
"first_name": "KEITH",
"middle_name": "ALAN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-12-23",
"last_updated": "2011-12-23",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "FL",
"license": "PS019151",
"primary": true
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "AL",
"license": "10305",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Riverview, FL
- Holiday CVS LLC (CVS Pharmacy #17311)
- Holiday CVS LLC (CVS Pharmacy 03638)
- Holiday CVS LLC (CVS Pharmacy #11483)
- Holiday CVS LLC (CVS Pharmacy 05784)
- Caitlin Suzanne Holland, NRP, PA-C
- Hongxen N Hollister, MD
- Home Sweet Home Legacy LLC
- Patrick Ryan Honeycutt, D.P.M.
- Richard Hood, RPH
- Tia Letricia Hooper, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.