MEDICARE: MR. KYROLLOS RAGHIB

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	122300000X	Dentist	DN26934	FL

General Provider Information

NPI Number	:	1740928217
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. KYROLLOS RAGHIB

Provider Business Mailing Address
First Line	:	2386 WALNUT HEIGHTS RD
Second Line	:
City	:	APOPKA
State	:	FL
Zip	:	32703-4856
Country	:	US
Telephone Number	:	407-760-2816
Fax Number	:

Provider Business Practice Location Address
First Line	:	2386 WALNUT HEIGHTS RD
Second Line	:
City	:	APOPKA
State	:	FL
Zip	:	32703-4856
Country	:	US
Telephone Number	:	407-760-2816
Fax Number	:

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

Provider Enumeration Date	:	05/24/2022
Last Update Date	:	06/06/2022

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Directions to “ MR. KYROLLOS RAGHIB ” Practice Location

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