Individual provider Active NPI

Mary Grace Del Rosario Garzon

  • Pharmacist
  • Clewiston, FL
National Provider Identifier
1972185965
Registry record updated Apr 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PS50319 Issued in FL
Practice address
1005 W Sugarland Hwy
Clewiston, FL 33440-2706
Phone
(863) 983-8756
NPI assigned
Apr 28, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PS50319 FL Primary

Addresses

Primary practice location

1005 W Sugarland Hwy
Clewiston, FL 33440-2706

Mailing address

500 N Francisco St Unit 231
Clewiston, FL 33440-2218
Phone (904) 444-8684

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

LicenseStateTypeSpecialty
PS50319FLMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1619568000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619568000000",
    "number": "1972185965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 N FRANCISCO ST UNIT 231",
            "city": "CLEWISTON",
            "state": "FL",
            "postal_code": "334402218",
            "telephone_number": "904-444-8684"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1005 W SUGARLAND HWY",
            "city": "CLEWISTON",
            "state": "FL",
            "postal_code": "334402706",
            "telephone_number": "863-983-8756"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARZON",
        "first_name": "MARY GRACE",
        "middle_name": "DEL ROSARIO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-28",
        "last_updated": "2021-04-28",
        "certification_date": "2021-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "FL",
            "license": "PS50319",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clewiston, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2021; 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.