Healthcare Provider Details

I. General information

NPI: 1639578057
Provider Name (Legal Business Name): SAVEEZ ZOGHI
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/21/2014
Last Update Date: 08/21/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4048 S SEMORAN BLVD
ORLANDO FL
32822-4062
US

IV. Provider business mailing address

4048 S SEMORAN BLVD
ORLANDO FL
32822-4062
US

V. Phone/Fax

Practice location:
  • Phone: 407-277-4848
  • Fax:
Mailing address:
  • Phone: 407-277-4848
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number52042
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: