Provider Demographics
NPI:1861129298
Name:AGURCIA, KAREN DENISSE
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:DENISSE
Last Name:AGURCIA
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 1:471 N PINE ISLAND RD APT D302
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33324-1830
Mailing Address - Country:US
Mailing Address - Phone:954-736-6224
Mailing Address - Fax:
Practice Address - Street 1:471 N PINE ISLAND RD APT D302
Practice Address - Street 2:
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33324-1830
Practice Address - Country:US
Practice Address - Phone:954-736-6224
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-05
Last Update Date:2022-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS64527183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist