Provider Demographics
NPI:1427651538
Name:AGAJ, SADINA (PHARMD)
Entity type:Individual
Prefix:
First Name:SADINA
Middle Name:
Last Name:AGAJ
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 1:17101 JOURNEYS END DR
Mailing Address - Street 2:
Mailing Address - City:ODESSA
Mailing Address - State:FL
Mailing Address - Zip Code:33556-2442
Mailing Address - Country:US
Mailing Address - Phone:813-765-8351
Mailing Address - Fax:
Practice Address - Street 1:11670 COUNTRYWAY BLVD
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33626-2738
Practice Address - Country:US
Practice Address - Phone:813-818-0287
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-19
Last Update Date:2020-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS51108183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist