Individual provider Active NPI

Gideon Amofa, PHARMD

  • Pharmacist
  • Fort Myers, FL
National Provider Identifier
1356859102
Registry record updated Jan 15, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PS56674 Issued in FL
Practice address
5997 S Pointe Blvd # 106
Fort Myers, FL 33919-3272
Phone
(239) 415-1515
NPI assigned
Jan 15, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PS56674 FL Primary

Addresses

Primary practice location

5997 S Pointe Blvd # 106
Fort Myers, FL 33919-3272

Mailing address

5610 Six Mile Commercial CT Apt 206
Fort Myers, FL 33912-4528
Phone (224) 678-4919

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
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
PS56674FLMDPharmacist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1515974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1515974400000",
    "number": "1356859102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5610 SIX MILE COMMERCIAL CT APT 206",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339124528",
            "telephone_number": "224-678-4919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5997 S POINTE BLVD # 106",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339193272",
            "telephone_number": "239-415-1515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMOFA",
        "first_name": "GIDEON",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-01-15",
        "last_updated": "2018-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "FL",
            "license": "PS56674",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Myers, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2018; 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.