Healthcare Provider Details
I. General information
NPI: 1548285174
Provider Name (Legal Business Name): HORACIO FRANCISCO ZAGLUL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 07/13/2006
Last Update Date: 07/16/2014
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
740 S LIMESTONE
LEXINGTON KY
40536-0001
US
IV. Provider business mailing address
2333 ALUMNI PARK PLZ SUITE 200
LEXINGTON KY
40517-4012
US
V. Phone/Fax
- Phone: 859-323-5481
- Fax:
- Phone: 859-257-7910
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2080P0203X |
| Taxonomy | Pediatric Critical Care Medicine Physician |
| License Number | 36113 |
| License Number State | KY |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2080H0002X |
| Taxonomy | Pediatric Hospice and Palliative Medicine Physician |
| License Number | 36113 |
| License Number State | KY |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: