BAYSIDE LAKES PHARMACY LLC NPI 1932686615

NPI Information

  • NPI: 1932686615
  • Provider Name: BAYSIDE LAKES PHARMACY LLC
  • Classification: Pharmacy - 3336C0003X
  • Specialization: Community/Retail Pharmacy
  • Entity Type: Organization
  • Doing Business As: BAYSIDE LAKES FAMILY PHARMACY
  • CLIA Number: 10D2279106
  • Address: 1850 ELDRON BLVD SE STE 7
    PALM BAY, FL
    ZIP 32909
  • Phone: (321) 308-0303

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NPI Details

BAYSIDE LAKES PHARMACY LLC is a community/retail pharmacy pharmacy in Palm Bay, FL. The provider is a pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes. BAYSIDE LAKES PHARMACY LLC NPI is 1932686615. The provider is registered as an organization entity type.
The provider Is Doing Business As Bayside Lakes Family Pharmacy.

The provider's business location address is:

1850 ELDRON BLVD SE STE 7
PALM BAY, FL
ZIP 32909-870
Phone: (321) 308-0303
Fax: (321) 308-0310

The provider's authorized official is Susan Elizabeth Macdonald .
The authorized official title is Owner and has the following contact phone number (321) 308-0303.

The CLIA number assigned to this NPI record is 10D2279106 - physician office with a certificate type of Certificate of Waiver.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Intramuscular administration of single severe acute respiratory syndrome coronavirus 2 (covid-19) vaccine, dna, spike protein, adenovirus type 26 (ad26) vector, preservative free, 5x1010 viral particles/0.5ml dosage, single dose (HCPCS:0031A)

The enumeration date for this NPI number is 7/25/2018 and was last updated on 12/21/2018.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1333600000XPharmacyNo
23336C0004XPharmacyCompounding PharmacyNo
33336C0003XPharmacyCommunity/Retail PharmacyPH31554FLORIDAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1PH31554OTHERFLORIDABOARD OF PHARMACY
2100868600MEDICAIDFLORIDA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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