MEDICARE: MR. AMGAD ESTAFAN RPH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	PS38596	FL

General Provider Information

NPI Number	:	1023388055
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. AMGAD ESTAFAN RPH

Provider Business Mailing Address
First Line	:	409 E MICHIGAN ST
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32806-4541
Country	:	US
Telephone Number	:	321-888-2222
Fax Number	:

Provider Business Practice Location Address
First Line	:	409 E MICHIGAN ST
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32806-4541
Country	:	US
Telephone Number	:	321-888-2222
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/06/2012
Last Update Date	:	06/17/2024

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