Individual provider Active NPI

Mohamed Dembele, PHARM.D.

  • Pharmacist
  • Lakeland, FL
National Provider Identifier
1417287418
Registry record updated Mar 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PS46884 Issued in FL
Practice address
722 E Memorial Blvd
Lakeland, FL 33801-1848
Phone
(863) 583-4999
Fax
(863) 583-4998
NPI assigned
Jan 13, 2010
Last updated
Mar 16, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X S014969 AZ
Pharmacist 183500000X PS46884 FL Primary

Addresses

Primary practice location

722 E Memorial Blvd
Lakeland, FL 33801-1848

Mailing address

722 E Memorial Blvd
Lakeland, FL 33801-1848
Phone (863) 583-4999

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
S014969AZMDPharmacist
PS46884FLMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Med & Co Investment LLC Current Accepting new patients
Medhealth Services LLC Current Accepting new patients
Med & Co Investment LLC Pharmacist Current Accepting new patients

Locations

722 E Memorial Blvd
Lakeland, FL 33801
Phone (863) 397-8626

Organizations & group practices 4

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": "1263340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521158400000",
    "number": "1417287418",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "722 E MEMORIAL BLVD",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338011848",
            "telephone_number": "863-583-4999",
            "fax_number": "863-583-4998"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "722 E MEMORIAL BLVD",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338011848",
            "telephone_number": "863-583-4999",
            "fax_number": "863-583-4998"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEMBELE",
        "first_name": "MOHAMED",
        "name_prefix": "Dr.",
        "credential": "PHARM.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-01-13",
        "last_updated": "2018-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "AZ",
            "license": "S014969",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "FL",
            "license": "PS46884",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakeland, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 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.