Provider Demographics
NPI:1982358404
Name:GIRGIS, WAGIH
Entity Type:Individual
Prefix:
First Name:WAGIH
Middle Name:
Last Name:GIRGIS
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 1:11936 SEMINOLE BLVD
Mailing Address - Street 2:
Mailing Address - City:LARGO
Mailing Address - State:FL
Mailing Address - Zip Code:33778-2803
Mailing Address - Country:US
Mailing Address - Phone:727-585-2000
Mailing Address - Fax:
Practice Address - Street 1:11936 SEMINOLE BLVD
Practice Address - Street 2:
Practice Address - City:LARGO
Practice Address - State:FL
Practice Address - Zip Code:33778-2803
Practice Address - Country:US
Practice Address - Phone:727-585-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-04
Last Update Date:2022-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJRI24339183500000X
FLPS36796183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist