Healthcare Provider Details

I. General information

NPI: 1366086878
Provider Name (Legal Business Name): JENNIFER LETIZIA ZAGORIA PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/29/2019
Last Update Date: 10/29/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8550 STIRLING RD
DAVIE FL
33024
US

IV. Provider business mailing address

1164 NW 134TH AVE
SUNRISE FL
33323-2913
US

V. Phone/Fax

Practice location:
  • Phone: 954-628-1771
  • Fax:
Mailing address:
  • Phone: 954-661-8561
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPS45051
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: