Healthcare Provider Details

I. General information

NPI: 1659690360
Provider Name (Legal Business Name): SMZA ENTERPRISES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/19/2010
Last Update Date: 02/06/2020
Certification Date: 02/06/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

754 S GOLDENROD RD
ORLANDO FL
32822-8108
US

IV. Provider business mailing address

754 S GOLDENROD RD
ORLANDO FL
32822-8108
US

V. Phone/Fax

Practice location:
  • Phone: 407-347-2463
  • Fax: 407-243-2223
Mailing address:
  • Phone: 407-243-2513
  • Fax: 407-243-2223

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberPH24767
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: BEHROOZ SOJERI
Title or Position: PHARMACIST/OWNER
Credential:
Phone: 407-243-2513