Individual provider Active NPI

Basharu Agbere, PHARMD

  • Pharmacist
  • Altamonte Springs, FL
National Provider Identifier
1447520309
Registry record updated Jan 10, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PS41166 Issued in FL
Practice address
113 Maitland Ave
Altamonte Springs, FL 32701-4901
Phone
(407) 331-4698
Fax
(407) 331-5302
NPI assigned
Jan 10, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PS41166 FL Primary

Addresses

Primary practice location

113 Maitland Ave
Altamonte Springs, FL 32701-4901

Mailing address

2081 Rocky Bluff CT
Oviedo, FL 32765-5932
Phone (407) 964-1196

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
PS41166FLMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1326153600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1326153600000",
    "number": "1447520309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2081 ROCKY BLUFF CT",
            "city": "OVIEDO",
            "state": "FL",
            "postal_code": "327655932",
            "telephone_number": "407-964-1196",
            "fax_number": "407-331-5302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "113 MAITLAND AVE",
            "city": "ALTAMONTE SPRINGS",
            "state": "FL",
            "postal_code": "327014901",
            "telephone_number": "407-331-4698",
            "fax_number": "407-331-5302"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AGBERE",
        "first_name": "BASHARU",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-01-10",
        "last_updated": "2012-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "FL",
            "license": "PS41166",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Altamonte Springs, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2012; 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.