Individual provider Active NPI

Ibrahim Shraim, ARNP

  • Nurse Practitioner
  • Oviedo, FL
National Provider Identifier
1023528692
Registry record updated Jun 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
ARNP9428064 Issued in FL
Practice address
7250 Red Bug Lake Rd Ste 1008
Oviedo, FL 32765-9290
Phone
(407) 542-0911
Fax
(407) 542-0950
NPI assigned
Oct 9, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X ARNP9428064 FL Primary

Addresses

Primary practice location

7250 Red Bug Lake Rd Ste 1008
Oviedo, FL 32765-9290

Mailing address

6675 Westwood Blvd Ste 475
Orlando, FL 32821-6027
Phone (407) 845-0330

Other practice location 1

173 N Charles Richard Beall Blvd Ste 106
Debary, FL 32713-2211
Phone (386) 284-8845

Other practice location 2

2432 S French Ave
Sanford, FL 32771-4276
Phone (407) 768-4464

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180418000618 FL Practitioner - Nurse Practitioner 1951664366

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
ARNP9428064FLMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Home Alliance LLC CurrentSince Mar 27, 2022 Accepting new patients
Medical Home Alliance LLC Past Accepting new patients

Locations

6675 Westwood Blvd
Ste 475
Orlando, FL 32821
Phone (407) 845-0384

7250 Red Bug Lake Rd
Ste 1008
Oviedo, FL 32765
Phone (407) 542-0911

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": "1507507200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685664000000",
    "number": "1023528692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6675 WESTWOOD BLVD STE 475",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328216027",
            "telephone_number": "407-845-0330",
            "fax_number": "888-972-1752"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7250 RED BUG LAKE RD STE 1008",
            "city": "OVIEDO",
            "state": "FL",
            "postal_code": "327659290",
            "telephone_number": "407-542-0911",
            "fax_number": "407-542-0950"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "173 N Charles Richard Beall Blvd Ste 106",
            "address_purpose": "LOCATION",
            "city": "Debary",
            "state": "FL",
            "postal_code": "327132211",
            "country_code": "US",
            "telephone_number": "386-284-8845",
            "fax_number": "407-270-6383",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2432 S French Ave",
            "address_purpose": "LOCATION",
            "city": "Sanford",
            "state": "FL",
            "postal_code": "327714276",
            "country_code": "US",
            "telephone_number": "407-768-4464",
            "fax_number": "407-878-0114",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHRAIM",
        "first_name": "IBRAHIM",
        "name_prefix": "Mr.",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-10-09",
        "last_updated": "2023-06-02",
        "certification_date": "2023-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "ARNP9428064",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oviedo, FL

Sources for this page

Verify at the official NPI Registry.