Healthcare Provider Details

I. General information

NPI: 1205742020
Provider Name (Legal Business Name): SHAGHAYEGH MOUSAVI PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SHAY MOUSAVI PHARMD

II. Dates (important events)

Enumeration Date: 08/21/2026
Last Update Date: 08/21/2026
Certification Date: 08/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3600 WASHINGTON ST
HOLLYWOOD FL
33021-8216
US

IV. Provider business mailing address

5571 LAKESIDE DR APT 101
MARGATE FL
33063-7659
US

V. Phone/Fax

Practice location:
  • Phone: 954-518-5685
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPS71370
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: