Provider Demographics
NPI:1821438847
Name:BOGHOSSIAN, LILIYA (PHARMD)
Entity Type:Individual
Prefix:
First Name:LILIYA
Middle Name:
Last Name:BOGHOSSIAN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2363 SE 15TH ST
Mailing Address - Street 2:
Mailing Address - City:POMPANO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33062-7502
Mailing Address - Country:US
Mailing Address - Phone:954-547-4544
Mailing Address - Fax:
Practice Address - Street 1:6602 N FEDERAL HWY
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33308-1410
Practice Address - Country:US
Practice Address - Phone:954-351-9103
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-05
Last Update Date:2013-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS37736183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist