Active NPI
Fady Bakhet
- Pharmacist
- Port Saint Lucie, FL
National Provider Identifier
1689277964
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PS54390
- Practice address
- 301 E Prima Vista Blvd
Port Saint Lucie, FL 34983-8432 - Phone
- (772) 340-3640
- Fax
- (772) 871-6186
- NPI assigned
- Nov 18, 2020
- 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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | PS54390 | FL | Primary |
Addresses
Primary practice location
301 E Prima Vista Blvd
Port Saint Lucie, FL 34983-8432
Mailing address
301 E Prima Vista Blvd
Port Saint Lucie, FL 34983-8432
Phone (772) 340-3640
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 |
|---|---|---|---|
| PS54390 | FL | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Holiday CVS L.L.C. | 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 and National Provider Directory roles.
-
- Pharmacy
- Wesley Chapel, FL
- NPI 1770467466
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1605657600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1605657600000",
"number": "1689277964",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "301 E PRIMA VISTA BLVD",
"city": "PORT SAINT LUCIE",
"state": "FL",
"postal_code": "349838432",
"telephone_number": "772-340-3640",
"fax_number": "772-871-6186"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "301 E PRIMA VISTA BLVD",
"city": "PORT SAINT LUCIE",
"state": "FL",
"postal_code": "349838432",
"telephone_number": "772-340-3640",
"fax_number": "772-871-6186"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BAKHET",
"first_name": "FADY",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-11-18",
"last_updated": "2020-11-18",
"certification_date": "2020-11-18",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "FL",
"license": "PS54390",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Port Saint Lucie, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.