Provider Demographics
NPI:1124129291
Name:GIRGIS, AMANY
Entity type:Individual
Prefix:MRS
First Name:AMANY
Middle Name:
Last Name:GIRGIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:747 SUNFLOWER CIR
Mailing Address - Street 2:
Mailing Address - City:WESTON
Mailing Address - State:FL
Mailing Address - Zip Code:33327-2113
Mailing Address - Country:US
Mailing Address - Phone:954-660-0464
Mailing Address - Fax:954-704-9082
Practice Address - Street 1:17101 MIRAMAR PKWY
Practice Address - Street 2:
Practice Address - City:MIRAMAR
Practice Address - State:FL
Practice Address - Zip Code:33027-4565
Practice Address - Country:US
Practice Address - Phone:954-704-9890
Practice Address - Fax:954-704-9082
Is Sole Proprietor?:No
Enumeration Date:2006-09-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS38946183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL0556050966Medicare ID - Type Unspecified