Active NPI
Mohamad Zeidan
- Pharmacist
- Lake Mary, FL
National Provider Identifier
1831520253
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PS51417
- Practice address
- 4106 W Lake Mary Blvd Ste 130
Lake Mary, FL 32746-3383 - Phone
- (407) 878-7615
- NPI assigned
- Dec 11, 2013
- Last updated
- Dec 11, 2013
- Sex
- Male
- Sole proprietor
- Yes
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 | PS51417 | FL | Primary |
Addresses
Primary practice location
4106 W Lake Mary Blvd Ste 130
Lake Mary, FL 32746-3383
Mailing address
2837 Sunlake Loop Apt 311
Lake Mary, FL 32746
UM
Phone (407) 256-2854
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 |
|---|---|---|---|
| PS51417 | FL | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Tirumala Pharmacy Inc | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1386720000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1386720000000",
"number": "1831520253",
"addresses": [
{
"country_code": "UM",
"country_name": "United States Minor Outlying Islands",
"address_purpose": "MAILING",
"address_type": "FGN",
"address_1": "2837 SUNLAKE LOOP APT 311",
"city": "LAKE MARY",
"state": "FL",
"postal_code": "32746",
"telephone_number": "407-256-2854"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4106 W LAKE MARY BLVD STE 130",
"city": "LAKE MARY",
"state": "FL",
"postal_code": "327463383",
"telephone_number": "407-878-7615"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ZEIDAN",
"first_name": "MOHAMAD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2013-12-11",
"last_updated": "2013-12-11",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "FL",
"license": "PS51417",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lake Mary, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.