Provider Demographics
NPI:1538957287
Name:HEGAZY, AMAL A (RPH)
Entity type:Individual
Prefix:
First Name:AMAL
Middle Name:A
Last Name:HEGAZY
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2555 S ATLANTIC AVE APT 1104
Mailing Address - Street 2:
Mailing Address - City:DAYTONA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32118-5536
Mailing Address - Country:US
Mailing Address - Phone:407-733-1003
Mailing Address - Fax:407-733-1003
Practice Address - Street 1:2555 S ATLANTIC AVE APT 1104
Practice Address - Street 2:
Practice Address - City:DAYTONA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32118-5536
Practice Address - Country:US
Practice Address - Phone:407-733-1003
Practice Address - Fax:407-733-1003
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-30
Last Update Date:2025-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS30117183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist