Individual provider Active NPI

Antoine Mourani

  • Pharmacist
  • Fort Lauderdale, FL
National Provider Identifier
1104335322
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PS54673 Issued in FL
Practice address
1303 SE 17TH St
Suite D1
Fort Lauderdale, FL 33316
Phone
(954) 687-0774
NPI assigned
Sep 20, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PS54673 FL Primary

Addresses

Primary practice location

1303 SE 17TH St
Suite D1
Fort Lauderdale, FL 33316

Mailing address

1303 SE 17TH St Ste D1
Fort Lauderdale, FL 33316-1722
Phone (954) 687-0774

Other identifiers 1

IdentifierTypeStateIssuer
PS54673OtherFLBOARD OF PHARMACY

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

State licenses

LicenseStateTypeSpecialty
PS54673FLMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
A Plus Pharmacy & Medical Supply PastSince Jul 24, 2022 Accepting new patients

Organizations & group practices 1

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": "1505865600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1104335322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1303 SE 17TH ST STE D1",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333161722",
            "telephone_number": "954-687-0774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1303 SE 17TH ST",
            "address_2": "SUITE D1",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "33316",
            "telephone_number": "954-687-0774"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOURANI",
        "first_name": "ANTOINE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-09-20",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "FL",
            "license": "PS54673",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BOARD OF PHARMACY",
            "identifier": "PS54673",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Lauderdale, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.