Active NPI
Israel Enechukwu, PHARMD
- Pharmacist
- Lakeland, FL
National Provider Identifier
1841957503
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PS43432
- Practice address
- 1611 N Florida Ave
Lakeland, FL 33805-3107 - Phone
- (863) 940-4733
- Fax
- (863) 940-4734
- NPI assigned
- Nov 17, 2021
- Last updated
- Nov 17, 2021
- 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 | PS43432 | FL | Primary |
Addresses
Primary practice location
1611 N Florida Ave
Lakeland, FL 33805-3107
Mailing address
PO Box 90014
Lakeland, FL 33804-0014
Phone (863) 940-4733
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
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PS43432 | FL | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Evercare Inc | Current | Accepting new patients |
Locations
1611 N Florida Ave
Lakeland, FL 33805
Phone (443) 980-2011
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": "1637107200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1637107200000",
"number": "1841957503",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 90014",
"city": "LAKELAND",
"state": "FL",
"postal_code": "338040014",
"telephone_number": "863-940-4733",
"fax_number": "863-940-4734"
},
{
"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",
"fax_number": "863-940-4734"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ENECHUKWU",
"first_name": "ISRAEL",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-11-17",
"last_updated": "2021-11-17",
"certification_date": "2021-11-17",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "FL",
"license": "PS43432",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lakeland, FL
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- Alicia Engwall
- Enhanced Lifestyle Senior Healthcare LLC
- Enhanced Lifestyle Senior Healthcare LLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.