Jad Ibrahim

Primary specialty

PharmacistTaxonomy code 183500000X

License

PS55277 Issued in FL

Practice address

3413 S Hopkins Ave
Titusville, FL 32780-5624

Phone

(321) 446-5460

NPI assigned

Aug 4, 2016

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Jad Family Pharmacy LLC

  • Community/Retail Pharmacy
  • Titusville, FL
  • NPI 1083303770
  NPD Authorized official
• Walgreen Co

  • Pharmacy
  • West Palm Beach, FL
  • NPI 1083629224
  NPD (past)
• Walgreen Co

  • Pharmacy
  • Longview, TX
  • NPI 1629956545
  NPD (past)

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

{
    "created_epoch": "1470268800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715644800000",
    "number": "1003360322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3413 S HOPKINS AVE",
            "city": "TITUSVILLE",
            "state": "FL",
            "postal_code": "327805624",
            "telephone_number": "321-446-5460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3413 S HOPKINS AVE",
            "city": "TITUSVILLE",
            "state": "FL",
            "postal_code": "327805624",
            "telephone_number": "321-446-5460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IBRAHIM",
        "first_name": "JAD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-08-04",
        "last_updated": "2024-05-14",
        "certification_date": "2024-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "FL",
            "license": "PS55277",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rebecca J Human, APRN
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• Camille Lanelle Hunter, LCSW
• Mary Rachael Hutchison, FNP-C
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• Imran Rashid MD PA
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• Infectious Diseases Specialist of Brevard LLC

• Pharmacist in Titusville, FL
• Providers in Titusville, FL by specialty
• Pharmacist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2024; 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.