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General NPI Number Information
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NPI Number | 1245743251
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Entity Type | Organization
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Legal Business Name | RALPH M ZAGHA MD PA
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Dates
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Enumeration Date | 11/13/2017
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Last Update Date | 11/29/2017
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Provider Practice Location Address
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Address Line | 2951 NW 49TH AVE STE 205
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City | LAUD LAKES
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State | FL
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Zip | 33313-1608
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Country | US
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Telephone | 954-652-0246
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Fax | 954-652-0471
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Provider Business Mailing Address
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Address Line | 2951 NW 49TH AVE STE 205
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City | LAUD LAKES
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State | FL
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Zip | 33313-1608
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Country | US
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Telephone | 954-652-0246
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Fax | 954-652-0471
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. RALPH M ZAGHA
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Credential | M.D.
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Telephone | 954-652-0246
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208800000X
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Taxonomy Name | Urology Physician
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License Number | ME95299
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License Number State | FL
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