Healthcare Provider Details

I. General information

NPI: 1295366011
Provider Name (Legal Business Name): AV INTERNATIONAL LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/30/2020
Last Update Date: 09/15/2022
Certification Date: 09/15/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2775 OLD WINTER GARDEN RD STE 2775
OCOEE FL
34761-2995
US

IV. Provider business mailing address

10375 RICHMOND AVE STE 700
HOUSTON TX
77042-4165
US

V. Phone/Fax

Practice location:
  • Phone: 407-813-1800
  • Fax: 407-813-1808
Mailing address:
  • Phone: 713-337-3016
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: ZIA M GHEEWALA
Title or Position: VP OF PHARMACY OPERATIONS
Credential:
Phone: 713-337-3016