Individual provider Active NPI

Ivan Vila, PHARMD

  • Pharmacist
  • Altamonte Springs, FL
National Provider Identifier
1972107191
Registry record updated Nov 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PS50716 Issued in FL
Practice address
1098 Montgomery Rd
Altamonte Springs, FL 32714-7420
Phone
(407) 869-6463
Fax
(407) 869-7318
NPI assigned
Nov 29, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 29, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PS50716 FL Primary

Addresses

Primary practice location

1098 Montgomery Rd
Altamonte Springs, FL 32714-7420

Mailing address

1098 Montgomery Rd
Altamonte Springs, FL 32714-7420
Phone (407) 869-6463

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

LicenseStateTypeSpecialty
PS50716FLMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1606608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606608000000",
    "number": "1972107191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1098 MONTGOMERY RD",
            "city": "ALTAMONTE SPRINGS",
            "state": "FL",
            "postal_code": "327147420",
            "telephone_number": "407-869-6463",
            "fax_number": "407-869-7318"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1098 MONTGOMERY RD",
            "city": "ALTAMONTE SPRINGS",
            "state": "FL",
            "postal_code": "327147420",
            "telephone_number": "407-869-6463",
            "fax_number": "407-869-7318"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VILA",
        "first_name": "IVAN",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-11-29",
        "last_updated": "2020-11-29",
        "certification_date": "2020-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "FL",
            "license": "PS50716",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Altamonte Springs, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2020; 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.