Provider Demographics
NPI:1366449456
Name:SOGOLOFF, HARVEY M
Entity Type:Individual
Prefix:MR
First Name:HARVEY
Middle Name:M
Last Name:SOGOLOFF
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 1:5840 STIRLING RD
Mailing Address - Street 2:HOLLYWOOD
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33021-1527
Mailing Address - Country:US
Mailing Address - Phone:954-987-4222
Mailing Address - Fax:954-986-2927
Practice Address - Street 1:70 W 49TH ST
Practice Address - Street 2:HIALEAH
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012-3710
Practice Address - Country:US
Practice Address - Phone:305-231-3199
Practice Address - Fax:954-986-2027
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPH12194183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist