JUSTIN RYAN CERAVOLO (NPI# 1144586447) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1144586447 |
| Entity Type | Individual |
| Full Name | JUSTIN RYAN CERAVOLO |
| Credential | PHARM.D. |
| Practice Address |
9451 Cypress Lake Dr Fort Myers FL 33919-4909 |
| Practice Telephone | 2394817322 |
| Practice Fax Number | 2394810151 |
| Mailing Telephone | 2394817322 |
| Mailing Fax Number | 2394810151 |
| Enumeration Date | 2012-04-11 |
| Last Update Date | 2016-08-29 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 183500000X | Pharmacist | PS 49258 | FL | Pharmacy Service Providers |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | PSI24223 | FL | Student, Health Care |
| Street Address |
9451 CYPRESS LAKE DR |
| City | FORT MYERS |
| State | FL |
| Zip Code | 33919-4909 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487739215 | Cypress Pharmacy Inc | Pharmacy | 9451 Cypress Lake Dr, Fort Myers, FL 33919-4909 | 2006-10-27 |
| 1346459971 | Thomas Jay Depaola Jr. | Pharmacist | 9451 Cypress Lake Dr, Fort Myers, FL 33919-4909 | 2007-05-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073145942 | Patricia June Briand | Registered Nurse | 4309 Mariner Way #307, Fort Myers, FL 33919 | 2020-02-10 |
| 1629556840 | The Onyx Counseling Center, LLC | Social Worker | 6361 Presidential Ct Ste 101, Fort Myers, FL 33919 | 2018-07-31 |
| 1366980187 | My Precious Kids Therapy Center Inc | Community/Behavioral Health | 4755 Summerlin Road, Suite #4, Fort Myers, FL 33919 | 2017-02-01 |
| 1811342397 | Kimberly Regenesis | Substance Abuse Rehabilitation Facility | 8695 College Parkway, Suite 2080, Ft Myers, FL 33919 | 2016-05-03 |
| 1689030207 | Balance for All, Inc. | Acupuncturist | 6238 Presidential Ct., Ste 6, Fort Myers, FL 33919 | 2016-01-12 |
| 1902275217 | Kelly Jean Overton | Physical Therapist | 6341 Whiskey Creek Drive, Fort Myers, FL 33919 | 2015-09-16 |
| 1508125311 | Charles Clark Dugan IIi | Chiropractor | 6309 Corporate Court, Suite 110, Fort Myers, FL 33919 | 2012-05-14 |
| 1659641231 | Dasha Bich Le | Pharmacist | 9629 Bay Harbor Cir., Apt. 201, Fort Myers, FL 33919 | 2012-01-12 |
| 1164792602 | Gail Lee Rathbun | Nurse Practitioner | 6311 S. Pointe Blvd., Fort Meyers, FL 33919 | 2011-12-30 |
| 1871878173 | Scott Kozlowski | Behavioral Analyst | 5335 Shalley Cir., Ft. Myers, FL 33919 | 2011-10-18 |
| Find all providers in zip 33919 | ||||
| Taxonomy Code | 183500000X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care. |
| Notes: Source: Adapted from National Association of Boards of Pharmacy Model State Pharmacy Act, Article 1, Section 104. [1/1/2006: definition modified, source modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871190678 | Melinda S Garner | Pharmacist | 14390 Reflection Lakes Dr, Fort Myers, FL 33907-1805 | 2020-10-05 |
| 1134766595 | Mamta Pradip Patel | Pharmacist | 9305 River Otter Dr, Fort Myers, FL 33912-8925 | 2019-12-04 |
| 1033754445 | Sherin Abraham George | Pharmacist | 15320 Sonoma Dr Apt 108, Fort Myers, FL 33908-7302 | 2019-11-08 |
| 1619512068 | Hardipsinh Gohil | Pharmacist | 14821 6 Mile Cypress Pkwy, Fort Myers, FL 33912-4467 | 2019-11-08 |
| 1417591983 | Mittal Chaudhari | Pharmacist | 9131 College Pkwy Ste 101, Fort Myers, FL 33919-4827 | 2019-10-29 |
| 1265095434 | Jon Thompson | Pharmacist | 8900 Oliveria St Apt 9703, Fort Myers, FL 33912-8992 | 2019-04-15 |
| 1447718705 | Archana Yamsani | Pharmacist | 18911 S Tamiami Trl, Fort Myers, FL 33908-4734 | 2019-03-06 |
| 1316418197 | Kellen Elayne Danley | Pharmacist | 12401 Commerce Lakes Dr Unit C, Fort Myers, FL 33913-8663 | 2018-12-05 |
| 1013492289 | Craig M Stein | Pharmacist | 15236 Tropic Bird Court, Fort Myers, FL 33908 | 2018-10-03 |
| 1245719954 | Lauren Grimes | Pharmacist | 13711 S Tamiami Trail, Fort Myers, FL 33912 | 2018-08-13 |
| Find all providers in FORT MYERS | ||||
| City | FORT MYERS |
| Zip Code | 33919 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.