Provider Demographics
NPI:1386366730
Name:TAGHIOFF, ILE MARJAN (PHARMD)
Entity type:Individual
Prefix:
First Name:ILE
Middle Name:MARJAN
Last Name:TAGHIOFF
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 1:1200 S FEDERAL HWY
Mailing Address - Street 2:
Mailing Address - City:DEERFIELD BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33441-7037
Mailing Address - Country:US
Mailing Address - Phone:954-429-9013
Mailing Address - Fax:954-281-1835
Practice Address - Street 1:1200 S FEDERAL HWY
Practice Address - Street 2:
Practice Address - City:DEERFIELD BEACH
Practice Address - State:FL
Practice Address - Zip Code:33441-7037
Practice Address - Country:US
Practice Address - Phone:954-429-9013
Practice Address - Fax:954-281-1835
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-13
Last Update Date:2022-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS61881183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist