Active NPI
Bassem Ramzy Boutros, RPH
- Pharmacist
- Clearwater, FL
National Provider Identifier
1265035646
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PS49708
- Practice address
- 30387 US Highway 19 N
Clearwater, FL 33761-1053 - Phone
- (727) 781-2955
- NPI assigned
- Nov 18, 2020
- 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 | PS49708 | FL | Primary |
Addresses
Primary practice location
30387 US Highway 19 N
Clearwater, FL 33761-1053
Mailing address
1768 Hawthorne CT
Oldsmar, FL 34677-5051
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 |
|---|---|---|---|
| PS49708 | FL | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1605657600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1605657600000",
"number": "1265035646",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1768 HAWTHORNE CT",
"city": "OLDSMAR",
"state": "FL",
"postal_code": "346775051"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "30387 US HIGHWAY 19 N",
"city": "CLEARWATER",
"state": "FL",
"postal_code": "337611053",
"telephone_number": "727-781-2955"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOUTROS",
"first_name": "BASSEM",
"middle_name": "RAMZY",
"credential": "RPH",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2020-11-18",
"last_updated": "2020-11-18",
"certification_date": "2020-11-18",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "FL",
"license": "PS49708",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Clearwater, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.