Active NPI
Ibrahim Fadeyi
- Pharmacist
- Lakeland, FL
National Provider Identifier
1235489998
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 49432
- Practice address
- 101 Ariana St
Lakeland, FL 33803-2159 - Phone
- (863) 688-5525
- NPI assigned
- Sep 10, 2012
- Last updated
- Sep 10, 2012
- 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 | 49432 | FL | Primary |
Addresses
Primary practice location
101 Ariana St
Lakeland, FL 33803-2159
Mailing address
11362 Brookgreen Dr
Tampa, FL 33624-5247
Phone (813) 380-0426
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
| License | State | Type | Specialty |
|---|---|---|---|
| 49432 | FL | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1347235200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1347235200000",
"number": "1235489998",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11362 BROOKGREEN DR",
"city": "TAMPA",
"state": "FL",
"postal_code": "336245247",
"telephone_number": "813-380-0426"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "101 ARIANA ST",
"city": "LAKELAND",
"state": "FL",
"postal_code": "338032159",
"telephone_number": "863-688-5525"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FADEYI",
"first_name": "IBRAHIM",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2012-09-10",
"last_updated": "2012-09-10",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "FL",
"license": "49432",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lakeland, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.