MEDICARE: RALPH M ZAGHA MD PA

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	208800000X	Urology Physician	ME95299	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1245743251
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RALPH M ZAGHA MD PA

Provider Business Mailing Address
First Line	:	2951 NW 49TH AVE STE 205
Second Line	:
City	:	LAUD LAKES
State	:	FL
Zip	:	33313-1608
Country	:	US
Telephone Number	:	954-652-0246
Fax Number	:	954-652-0471

Provider Business Practice Location Address
First Line	:	2951 NW 49TH AVE STE 205
Second Line	:
City	:	LAUD LAKES
State	:	FL
Zip	:	33313-1608
Country	:	US
Telephone Number	:	954-652-0246
Fax Number	:	954-652-0471

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. RALPH M ZAGHA
Credential	:	M.D.
Telephone Number	:	954-652-0246

Provider Enumeration Date	:	11/13/2017
Last Update Date	:	11/29/2017

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