Individual provider Active NPI

Wael Diab

  • Pharmacist
  • Tampa, FL
National Provider Identifier
1962005884
Registry record updated Nov 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PS39616 Issued in FL
Practice address
8603 W Hillsborough Ave
Tampa, FL 33615-3810
Phone
(813) 882-4029
NPI assigned
Nov 21, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 21, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PS39616 FL Primary

Addresses

Primary practice location

8603 W Hillsborough Ave
Tampa, FL 33615-3810

Mailing address

8830 Cameron Crest Dr
Tampa, FL 33626-4712

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
PS39616FLMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Holiday CVS L.L.C. PastSince Nov 29, 2020 Accepting new patients
Holiday CVS, L.L.C. PastSince Nov 29, 2020 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1605916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605916800000",
    "number": "1962005884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8830 CAMERON CREST DR",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336264712"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8603 W HILLSBOROUGH AVE",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336153810",
            "telephone_number": "813-882-4029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIAB",
        "first_name": "WAEL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-11-21",
        "last_updated": "2020-11-21",
        "certification_date": "2020-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "FL",
            "license": "PS39616",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 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.

Verify at the official NPI Registry.