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General NPI Number Information
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NPI Number | 1992506695
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Entity Type | Individual
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Provider Name | MAGDY FAM
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Gender | Male
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Dates
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Enumeration Date | 03/20/2025
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Last Update Date | 03/20/2025
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Provider Practice Location Address
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Address Line | 795 W GRANADA BLVD
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City | ORMOND BEACH
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State | FL
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Zip | 32174-9510
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Country | US
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Telephone | 386-672-7227
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Fax |
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Provider Business Mailing Address
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Address Line | 144 BLACK HICKORY WAY
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City | ORMOND BEACH
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State | FL
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Zip | 32174-5709
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Country | US
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Telephone | 718-759-7639
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PH20553
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License Number State | FL
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