Active NPI
Ahlam Faqqouseh
- Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
- Bradenton, FL
National Provider Identifier
1396499703
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
- License
- PS55938
- Practice address
- 6138 9TH Avenue Cir NE
Bradenton, FL 34212-9559 - Phone
- (941) 726-6638
- NPI assigned
- Feb 5, 2022
- 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 Clinician (PhC)/ Clinical Pharmacy Specialist | 1835P0018X | PS55938 | FL | Primary |
Addresses
Primary practice location
6138 9TH Avenue Cir NE
Bradenton, FL 34212-9559
Mailing address
6138 9TH Avenue Cir NE
Bradenton, FL 34212-9559
Phone (941) 726-6638
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 |
|---|---|---|---|
| PS55938 | FL | MD | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1644019200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1644019200000",
"number": "1396499703",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6138 9TH AVENUE CIR NE",
"city": "BRADENTON",
"state": "FL",
"postal_code": "342129559",
"telephone_number": "941-726-6638"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6138 9TH AVENUE CIR NE",
"city": "BRADENTON",
"state": "FL",
"postal_code": "342129559",
"telephone_number": "941-726-6638"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FAQQOUSEH",
"first_name": "AHLAM",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-02-05",
"last_updated": "2022-02-05",
"certification_date": "2022-02-05",
"status": "A"
},
"taxonomies": [
{
"code": "1835P0018X",
"taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
"desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
"state": "FL",
"license": "PS55938",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bradenton, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.