Abacoa Pharmacy Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

ABACOA PHARMACY INC

Practice address

500 University Blvd Ste 108
Jupiter, FL 33458-2774

Phone

(561) 660-7585

Fax

(561) 660-7594

NPI assigned

Jan 18, 2019

Organization subpart

No

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

Authorized official

Name

Salim Soufan

Title

RPH/Owner

Phone

(561) 660-7585

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• ABACOA PHARMACY Doing business as

Networks

• HealthSun Health Plans Network
• Optimum HealthCare HMO NetworkPlans: Optimum Diamond Rewards (HMO C-SNP) (H5594-028-000, H5594); Optimum Diamond (HMO C-SNP) (H5594-036-000, H5594); Optimum Diamond Rewards (HMO C-SNP) (H5594-034-000, H5594); Optimum Diamond Rewards COPD (HMO C-SNP) (H5594-029-000, H5594); Optimum Platinum Plan (HMO) (H5594-002-000, H5594); Optimum Gold Plus Plan (HMO) (H5594-032-000, H5594); Optimum Diamond Savings COPD (HMO C-SNP) (H5594-031-000, H5594); Optimum Diamond Savings (HMO C-SNP) (H5594-030-000, H5594); Optimum Diamond Rewards COPD (HMO C-SNP) (H5594-035-000, H5594)
• Freedom Health HMO NetworkPlans: Freedom Platinum Rewards Plan Rx (HMO) (H5427-102-000, H5427); Freedom VIP Care (HMO C-SNP) (H5427-070-000, H5427); Freedom VIP Rewards (HMO C-SNP) (H5427-108-000, H5427); Freedom VIP Rewards (HMO C-SNP) (H5427-099-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-107-000, H5427); Freedom Maximo (HMO-POS) (H5427-113-000, H5427); Freedom Savings Plan (HMO) (H5427-052-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-096-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-105-000, H5427); Freedom Medi-Medi Full (HMO D-SNP) (H5427-087-000, H5427)…

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Nicole Gates, PHARMD

  • Pharmacist
  • Jupiter, FL
  • NPI 1023593522
  NPD (past)

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

{
    "created_epoch": "1547769600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1777248000000",
    "number": "1407320807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 UNIVERSITY BLVD STE 108",
            "city": "JUPITER",
            "state": "FL",
            "postal_code": "334582774",
            "telephone_number": "561-660-7585",
            "fax_number": "561-660-7594"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 UNIVERSITY BLVD STE 108",
            "city": "JUPITER",
            "state": "FL",
            "postal_code": "334582774",
            "telephone_number": "561-660-7585",
            "fax_number": "561-660-7594"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ABACOA PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-01-18",
        "last_updated": "2026-04-27",
        "certification_date": "2026-04-27",
        "status": "A",
        "authorized_official_last_name": "SOUFAN",
        "authorized_official_first_name": "SALIM",
        "authorized_official_title_or_position": "RPH/OWNER",
        "authorized_official_telephone_number": "561-660-7585"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FLORIDA PHARMACY LICENSE",
            "identifier": "PH31846",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ABACOA PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• All providers in Jupiter, FL
• Community/Retail Pharmacy in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2026; 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.