Provider Demographics
NPI:1730256850
Name:KAZARIAN, DAVID W (RPH)
Entity type:Individual
Prefix:MR
First Name:DAVID
Middle Name:W
Last Name:KAZARIAN
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11880 28TH ST N
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33716-1824
Mailing Address - Country:US
Mailing Address - Phone:727-573-7847
Mailing Address - Fax:727-573-0535
Practice Address - Street 1:11880 28TH ST N
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33716-1824
Practice Address - Country:US
Practice Address - Phone:727-573-7847
Practice Address - Fax:727-573-0535
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-30
Last Update Date:2018-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT033-0002591183500000X
CT4144183500000X
FLPS 11034183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL593059261OtherEIN