Individual provider Active NPI

Casey Amendolaro, RPH

  • Pharmacy Technician
  • Melbourne, FL
National Provider Identifier
1992410914
Registry record updated Jan 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pharmacy TechnicianTaxonomy code 183700000X
License
RPT29772 Issued in FL
Practice address
3040 Venture LN Ste 103
Melbourne, FL 32934-8173
Phone
(321) 242-2996
NPI assigned
Jan 16, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy Technician 183700000X RPT29772 FL Primary

Addresses

Primary practice location

3040 Venture LN Ste 103
Melbourne, FL 32934-8173

Mailing address

1402 Knave LN
Malabar, FL 32950-3308
Phone (954) 655-5041

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
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
RPT29772FLMDPharmacy Technician

Practice roles

OrganizationSpecialtyStatusNew patients
Infusion Partners of Melbourne LLC CurrentSince Jan 22, 2023 Accepting new patients
Infusion Partners of Melbourne LLC PastSince Jan 22, 2023 Accepting new patients

Locations

3040 Venture Ln
Ste 103
Melbourne, FL 32934
Phone (321) 242-2996

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.

NPI Registry JSON

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

{
    "created_epoch": "1673827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673827200000",
    "number": "1992410914",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1402 KNAVE LN",
            "city": "MALABAR",
            "state": "FL",
            "postal_code": "329503308",
            "telephone_number": "954-655-5041"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3040 VENTURE LN STE 103",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329348173",
            "telephone_number": "321-242-2996"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMENDOLARO",
        "first_name": "CASEY",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-01-16",
        "last_updated": "2023-01-16",
        "certification_date": "2023-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183700000X",
            "taxonomy_group": "",
            "desc": "Pharmacy Technician",
            "state": "FL",
            "license": "RPT29772",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Melbourne, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2023; 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.