Active NPI
Samer A Shehaita, RPH
- Pharmacist
- Winter Haven, FL
National Provider Identifier
1114042264
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PS28842
- Practice address
- 705 1St St S
Winter Haven, FL 33880-3602 - Phone
- (863) 294-7487
- Fax
- (863) 299-0242
- NPI assigned
- Mar 20, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | PS28842 | FL | Primary |
Addresses
Primary practice location
705 1St St S
Winter Haven, FL 33880-3602
Mailing address
PO Box 422231
Kissimmee, FL 34742-2231
Phone (407) 973-4789
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
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PS28842 | FL | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | 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": "1174348800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1114042264",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 422231",
"city": "KISSIMMEE",
"state": "FL",
"postal_code": "347422231",
"telephone_number": "407-973-4789"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "705 1ST ST S",
"city": "WINTER HAVEN",
"state": "FL",
"postal_code": "338803602",
"telephone_number": "863-294-7487",
"fax_number": "863-299-0242"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHEHAITA",
"first_name": "SAMER",
"middle_name": "A",
"name_prefix": "Mr.",
"credential": "RPH",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-03-20",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "FL",
"license": "PS28842",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Winter Haven, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.