Provider Demographics
NPI:1982993986
Name:RAZAZI, FLORA (PHD)
Entity Type:Individual
Prefix:
First Name:FLORA
Middle Name:
Last Name:RAZAZI
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2080 RIDGER RD
Mailing Address - Street 2:
Mailing Address - City:CUMMING
Mailing Address - State:GA
Mailing Address - Zip Code:30041-6647
Mailing Address - Country:US
Mailing Address - Phone:404-441-2177
Mailing Address - Fax:
Practice Address - Street 1:12155 HOUZE RD
Practice Address - Street 2:
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30004-6647
Practice Address - Country:US
Practice Address - Phone:678-762-1429
Practice Address - Fax:678-762-7834
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-31
Last Update Date:2011-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH021367183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist