Provider Demographics
NPI:1245743251
Name:RALPH M ZAGHA MD PA
Entity Type:Organization
Organization Name:RALPH M ZAGHA MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RALPH
Authorized Official - Middle Name:M
Authorized Official - Last Name:ZAGHA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:954-652-0246
Mailing Address - Street 1:2951 NW 49TH AVE STE 205
Mailing Address - Street 2:
Mailing Address - City:LAUD LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:33313-1608
Mailing Address - Country:US
Mailing Address - Phone:954-652-0246
Mailing Address - Fax:954-652-0471
Practice Address - Street 1:2951 NW 49TH AVE STE 205
Practice Address - Street 2:
Practice Address - City:LAUD LAKES
Practice Address - State:FL
Practice Address - Zip Code:33313-1608
Practice Address - Country:US
Practice Address - Phone:954-652-0246
Practice Address - Fax:954-652-0471
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-13
Last Update Date:2017-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME95299208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty