Active NPI
William Charles Maiden, PHARMD
- Pharmacist
- Fort Myers, FL
National Provider Identifier
1871963587
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PS53863
- Practice address
- 16980 Alico Mission Way
Ste 403
Fort Myers, FL 33908-4851 - Phone
- (239) 489-0729
- Fax
- (239) 489-3496
- NPI assigned
- Oct 7, 2015
- 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 | PS53863 | FL | Primary |
Addresses
Primary practice location
16980 Alico Mission Way
Ste 403
Fort Myers, FL 33908-4851
Mailing address
16980 Alico Mission Way
Unit 403
Fort Myers, FL 33908-4851
Phone (304) 266-8895
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PS53863 | Other | FL | STATE-ISSUED |
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 |
|---|---|---|---|
| PS53863 | FL | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Publix Super Markets 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 and National Provider Directory roles.
-
- Community/Retail Pharmacy
- Winter Haven, FL
- NPI 1760356380
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1444176000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1489622400000",
"number": "1871963587",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16980 ALICO MISSION WAY",
"address_2": "UNIT 403",
"city": "FORT MYERS",
"state": "FL",
"postal_code": "339084851",
"telephone_number": "304-266-8895",
"fax_number": "239-489-3496"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16980 ALICO MISSION WAY",
"address_2": "STE 403",
"city": "FORT MYERS",
"state": "FL",
"postal_code": "339084851",
"telephone_number": "239-489-0729",
"fax_number": "239-489-3496"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAIDEN",
"first_name": "WILLIAM",
"middle_name": "CHARLES",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-10-07",
"last_updated": "2017-03-16",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "FL",
"license": "PS53863",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE-ISSUED",
"identifier": "PS53863",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Fort Myers, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.