Individual provider Active NPI

Kwame Nti Addae-Afoakwa

  • Pharmacist
  • Orlando, FL
National Provider Identifier
1508404948
Registry record updated Dec 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PS53601 Issued in FL
Practice address
902 Lee Rd
Orlando, FL 32810-5561
Phone
(407) 204-8739
Fax
(407) 204-8738
NPI assigned
Dec 17, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 49153 TX
Pharmacist 183500000X PS53601 FL Primary

Addresses

Primary practice location

902 Lee Rd
Orlando, FL 32810-5561

Mailing address

117 Majestic Forest Run
Sanford, FL 32771-7172
Phone (407) 325-5492

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

LicenseStateTypeSpecialty
PS53601FLMDPharmacist
49153TXMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Wal-Mart Stores East LP PastSince Dec 22, 2019 Accepting new patients
Wal-Mart Stores East, LP PastSince Dec 22, 2019 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": "1576540800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576540800000",
    "number": "1508404948",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 MAJESTIC FOREST RUN",
            "city": "SANFORD",
            "state": "FL",
            "postal_code": "327717172",
            "telephone_number": "407-325-5492"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "902 LEE RD",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328105561",
            "telephone_number": "407-204-8739",
            "fax_number": "407-204-8738"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADDAE-AFOAKWA",
        "first_name": "KWAME",
        "middle_name": "NTI",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-12-17",
        "last_updated": "2019-12-17",
        "certification_date": "2019-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "TX",
            "license": "49153",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "FL",
            "license": "PS53601",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2019; 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.