Provider Demographics
NPI:1093827032
Name:AGBELI, CHRISTIAN C (RPH)
Entity Type:Individual
Prefix:MR
First Name:CHRISTIAN
Middle Name:C
Last Name:AGBELI
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8386 GOLDEN PRAIRIE DR
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33647-3241
Mailing Address - Country:US
Mailing Address - Phone:813-975-1552
Mailing Address - Fax:
Practice Address - Street 1:4941 E BUSCH BLVD
Practice Address - Street 2:NO. 240
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33617-6056
Practice Address - Country:US
Practice Address - Phone:813-980-6334
Practice Address - Fax:813-980-6338
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS29108183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist