Active NPI
Gisha Mary Abraham, RPH
- Pharmacist
- Lakeland, FL
National Provider Identifier
1760013957
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PS36295
- Practice address
- 1611 N Florida Ave
Lakeland, FL 33805-3107 - Phone
- (863) 940-4733
- NPI assigned
- Jan 28, 2020
- Last updated
- Jan 28, 2020
- Sex
- Female
- 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 | PS36295 | FL | Primary |
Addresses
Primary practice location
1611 N Florida Ave
Lakeland, FL 33805-3107
Mailing address
17604 Old Oak Way
Lithia, FL 33547-5026
Phone (813) 770-1394
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
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PS36295 | FL | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mulberry Food and Pharmacy LLC | Current | Accepting new patients | |
| Evercare Inc | Past | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Pharmacy
- Mulberry, FL
- NPI 1417588625
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1580169600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1580169600000",
"number": "1760013957",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17604 OLD OAK WAY",
"city": "LITHIA",
"state": "FL",
"postal_code": "335475026",
"telephone_number": "813-770-1394"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1611 N FLORIDA AVE",
"city": "LAKELAND",
"state": "FL",
"postal_code": "338053107",
"telephone_number": "863-940-4733"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ABRAHAM",
"first_name": "GISHA",
"middle_name": "MARY",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-01-28",
"last_updated": "2020-01-28",
"certification_date": "2020-01-28",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "FL",
"license": "PS36295",
"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 Jan 28, 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.