Active NPI
Michael E Ibrahim
- Critical Care Pharmacist
- Largo, FL
National Provider Identifier
1407353626
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Critical Care Pharmacist
- License
- PH100002997
- Practice address
- 1290 West Bay Drive
Largo, FL 33770 - Phone
- (727) 585-1333
- Fax
- (727) 585-1344
- NPI assigned
- Apr 13, 2018
- Last updated
- Apr 13, 2018
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Critical Care Pharmacist | 1835C0205X | PH100002997 | DC | Primary |
Addresses
Primary practice location
1290 West Bay Drive
Largo, FL 33770
Mailing address
155 Kristen CT Apt 609
Palm Harbor, FL 34684
Phone (727) 488-1296
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 |
|---|---|---|---|
| PH100002997 | DC | MD | Critical Care Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| St Mary Pharmacy LLC | Past | Accepting new patients |
Organizations & group practices 1
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": "1523577600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1523577600000",
"number": "1407353626",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "155 KRISTEN CT APT 609",
"city": "PALM HARBOR",
"state": "FL",
"postal_code": "34684",
"telephone_number": "727-488-1296"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1290 WEST BAY DRIVE",
"city": "LARGO",
"state": "FL",
"postal_code": "33770",
"telephone_number": "727-585-1333",
"fax_number": "727-585-1344"
}
],
"practiceLocations": [],
"basic": {
"last_name": "IBRAHIM",
"first_name": "MICHAEL",
"middle_name": "E",
"name_prefix": "Mr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-04-13",
"last_updated": "2018-04-13",
"status": "A"
},
"taxonomies": [
{
"code": "1835C0205X",
"taxonomy_group": "",
"desc": "Pharmacist, Critical Care",
"state": "DC",
"license": "PH100002997",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 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.