Individual provider Active NPI

Mohamed Abuhulwa

  • Pharmacist
  • Jacksonville, FL
National Provider Identifier
1790597904
Registry record updated Jan 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PS68065 Issued in FL
Practice address
10765 Ironstone Dr S
Jacksonville, FL 32246-9764
Phone
(828) 394-7481
NPI assigned
Jan 23, 2025
Last updated
Jan 23, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PS68065 FL Primary

Addresses

Primary practice location

10765 Ironstone Dr S
Jacksonville, FL 32246-9764

Mailing address

10765 Ironstone Dr S
Jacksonville, FL 32246-9764
Phone (828) 394-7481

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
PS68065FLMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1737590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737590400000",
    "number": "1790597904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10765 IRONSTONE DR S",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322469764",
            "telephone_number": "828-394-7481"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10765 IRONSTONE DR S",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322469764",
            "telephone_number": "828-394-7481"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABUHULWA",
        "first_name": "MOHAMED",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-01-23",
        "last_updated": "2025-01-23",
        "certification_date": "2025-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "FL",
            "license": "PS68065",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2025; 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.