Active NPI
Ansel Avila
- Pharmacist
- Jacksonville, FL
National Provider Identifier
1982209466
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PS61242
- Practice address
- 5999 Normandy Blvd
Jacksonville, FL 32205-6265 - Phone
- (904) 786-2148
- NPI assigned
- Dec 2, 2020
- Sex
- Male
- 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 | PS61242 | FL | Primary |
Addresses
Primary practice location
5999 Normandy Blvd
Jacksonville, FL 32205-6265
Mailing address
159 Sentosa Dr Unit 207
St Johns, FL 32259-9192
Phone (714) 876-8423
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 |
|---|---|---|---|
| PS61242 | FL | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Holiday CVS LLC | Past | Accepting new patients | |
| Holiday CVS L.L.C. | 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 and National Provider Directory roles.
-
- Pharmacy
- Wesley Chapel, FL
- NPI 1770467466
-
- Pharmacy
- Jacksonville, FL
- NPI 1578667457
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1606867200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1606867200000",
"number": "1982209466",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "159 SENTOSA DR UNIT 207",
"city": "ST JOHNS",
"state": "FL",
"postal_code": "322599192",
"telephone_number": "714-876-8423"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5999 NORMANDY BLVD",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322056265",
"telephone_number": "904-786-2148"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AVILA",
"first_name": "ANSEL",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-12-02",
"last_updated": "2020-12-02",
"certification_date": "2020-11-28",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "FL",
"license": "PS61242",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jacksonville, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 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.