1306943725 NPI number — DR. ARTHUR L VERGA MD

Table of content: DR. ARTHUR L VERGA MD (NPI 1306943725)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1306943725 NPI number — DR. ARTHUR L VERGA MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
VERGA
Provider First Name:
ARTHUR
Provider Middle Name:
L
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1306943725
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/17/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7543 MEDICAL DRIVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HUDSON
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
34677
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
727-868-7800
Provider Business Mailing Address Fax Number:
727-868-7866

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7543 MEDICAL DRIVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HUDSON
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
34677
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
727-868-7800
Provider Business Practice Location Address Fax Number:
727-868-7866
Provider Enumeration Date:
09/20/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 208600000X , with the licence number:  ME49179 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 208C00000X , with the licence number: ME49179 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 210008 . This is a "AVMED PROVIDER NUMBER" identifier . This identifiers is of the category "OTHER".
  • Identifier: 06270 . This is a "UNIVERSAL PROVIDER NUMBER" identifier . This identifiers is of the category "OTHER".
  • Identifier: 01455 . This is a "BLUE SHIELD PROVIDER NUM" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 264852100 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 4110909 . This is a "AETNA PROVIDER NUMBER" identifier . This identifiers is of the category "OTHER".
  • Identifier: 240873 . This is a "WELLCARE PROVIDER NUMBER" identifier . This identifiers is of the category "OTHER".
  • Identifier: 220003259 . This is a "RAILROAD MEDICARE PTAN" identifier . This identifiers is of the category "OTHER".