Active NPI
Hedieh Kouchak
- Pharmacist
- Fern Park, FL
National Provider Identifier
1326863036
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PS67948
- Practice address
- 7815 S US Highway 17/92
Fern Park, FL 32730-2261 - Phone
- (407) 331-0968
- NPI assigned
- Nov 18, 2024
- Last updated
- Feb 5, 2025
- Sex
- Female
- 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 | PS67948 | FL | Primary |
Addresses
Primary practice location
7815 S US Highway 17/92
Fern Park, FL 32730-2261
Mailing address
7815 S US Highway 17/92
Fern Park, FL 32730-2261
Phone (407) 331-0968
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 |
|---|---|---|---|
| PS67948 | 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": "1731888000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1738713600000",
"number": "1326863036",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7815 S US HIGHWAY 17/92",
"city": "FERN PARK",
"state": "FL",
"postal_code": "327302261",
"telephone_number": "407-331-0968"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7815 S US HIGHWAY 17/92",
"city": "FERN PARK",
"state": "FL",
"postal_code": "327302261",
"telephone_number": "407-331-0968"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOUCHAK",
"first_name": "HEDIEH",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-11-18",
"last_updated": "2025-02-05",
"certification_date": "2025-02-05",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "FL",
"license": "PS67948",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fern Park, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.