MEDICARE: MR. CHRISTIAN C AGBELI 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	PS29108	FL

General Provider Information

NPI Number	:	1093827032
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. CHRISTIAN C AGBELI RPH

Provider Business Mailing Address
First Line	:	8386 GOLDEN PRAIRIE DR
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33647-3241
Country	:	US
Telephone Number	:	813-975-1552
Fax Number	:

Provider Business Practice Location Address
First Line	:	4941 E BUSCH BLVD
Second Line	:	NO. 240
City	:	TAMPA
State	:	FL
Zip	:	33617-6056
Country	:	US
Telephone Number	:	813-980-6334
Fax Number	:	813-980-6338

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

Provider Enumeration Date	:	08/31/2006
Last Update Date	:	07/08/2007

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