Provider Demographics
NPI:1255858676
Name:MIAZGA, FRANK
Entity Type:Individual
Prefix:DR
First Name:FRANK
Middle Name:
Last Name:MIAZGA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:383 EMERSON PLZ APT 415
Mailing Address - Street 2:
Mailing Address - City:ALTAMONTE SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32701-4058
Mailing Address - Country:US
Mailing Address - Phone:407-821-4868
Mailing Address - Fax:
Practice Address - Street 1:2354 COMMERCE PARK DR # 100
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32819-8601
Practice Address - Country:US
Practice Address - Phone:877-627-6337
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-25
Last Update Date:2017-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS50970183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist