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NPI Code Detail

MEDICARE: SAN MICHAEL COSMETICS, LLC

MEDICARE: SAN MICHAEL COSMETICS, LLC
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
1207R00000XInternal Medicine Physician

General Provider Information

NPI Number : 1578882197
Entity Type Code : Organization
Provider Name (Legal Business Name) : SAN MICHAEL COSMETICS, LLC
Provider Business Mailing Address
First Line : 1960 E BAY DR
Second Line :
City : LARGO
State : FL
Zip : 33771-2218
Country : US
Telephone Number : 727-535-6400
Fax Number :
Provider Business Practice Location Address
First Line : 1960 E BAY DR
Second Line :
City : LARGO
State : FL
Zip : 33771-2218
Country : US
Telephone Number : 727-535-6400
Fax Number :
Authorized Official
Title or Position : PRESIDENT / PHYSICIAN
Name : DR. WAGUIH EL MASRY
Credential : MD
Telephone Number : 727-535-6400
Provider Enumeration Date : 05/21/2010
Last Update Date : 05/21/2010

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Directions to “SAN MICHAEL COSMETICS, LLC ” Practice Location

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