Individual provider Active NPI

Kerolos Ibrahim, RPH

  • Pharmacist
  • Osprey, FL
National Provider Identifier
1497358477
Registry record updated Nov 20, 2020
On this page

OIG exclusion record

The HHS Office of Inspector General’s List of Excluded Individuals/Entities (LEIE) contains a record with this NPI:

  • Section 1128a(3) exclusion effective Jun 19, 2025.

Matched on NPI only. Confirm current status with the OIG exclusions search before relying on it.

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PSI59545 Issued in FL
Practice address
1220 S Tamiami TRL
Osprey, FL 34229
NPI assigned
Nov 20, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 20, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PSI59545 FL Primary

Addresses

Primary practice location

1220 S Tamiami TRL
Osprey, FL 34229

Mailing address

1220 S Tamiami TRL
Osprey, FL 34229-9692
Phone (941) 966-5667

Other practice location 1

1220 S Tamiami Trl
Osprey, FL 34229-9692

Other practice location 2

1220 S Tamiami Trl
Osprey, FL 34229-9692
Phone (941) 966-5667

Other practice location 3

1220 S Tamiami Trl
Osprey, FL 34229-9692
Phone (941) 966-5667

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
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.
Credentials
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
PSI59545FLMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Holiday CVS LLC. PastSince Nov 22, 2020 Accepting new patients
Holiday CVS L.L.C. PastSince Nov 22, 2020 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1605830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605830400000",
    "number": "1497358477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1220 S TAMIAMI TRL",
            "city": "OSPREY",
            "state": "FL",
            "postal_code": "342299692",
            "telephone_number": "941-966-5667"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1220 S TAMIAMI TRL",
            "city": "OSPREY",
            "state": "FL",
            "postal_code": "34229"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1220 S Tamiami Trl",
            "address_purpose": "LOCATION",
            "city": "Osprey",
            "state": "FL",
            "postal_code": "342299692",
            "country_code": "US",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1220 S Tamiami Trl",
            "address_purpose": "LOCATION",
            "city": "Osprey",
            "state": "FL",
            "postal_code": "342299692",
            "country_code": "US",
            "telephone_number": "941-966-5667",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1220 S Tamiami Trl",
            "address_purpose": "LOCATION",
            "city": "Osprey",
            "state": "FL",
            "postal_code": "342299692",
            "country_code": "US",
            "telephone_number": "941-966-5667",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "IBRAHIM",
        "first_name": "KEROLOS",
        "credential": "RPH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-11-20",
        "last_updated": "2020-11-20",
        "certification_date": "2020-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "FL",
            "license": "PSI59545",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Osprey, FL

Sources for this page

Verify at the official NPI Registry.