1326144742 NPI number — MISS DANA TAMARA BADUNA L.M.F.T.

Table of content: MISS DANA TAMARA BADUNA L.M.F.T. (NPI 1326144742)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1326144742 NPI number — MISS DANA TAMARA BADUNA L.M.F.T.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BADUNA
Provider First Name:
DANA
Provider Middle Name:
TAMARA
Provider Name Prefix Text:
MISS
Provider Name Suffix Text:
Provider Credential Text:
L.M.F.T.
Provider Gender Code:
F

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:
1326144742
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/09/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
300 CENTRAL AVE
Provider Second Line Business Mailing Address:
#605
Provider Business Mailing Address City Name:
ST PETERSBURG
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33701-3845
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
813-787-3883
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1135 PASADENA AVE S
Provider Second Line Business Practice Location Address:
SUITE 309
Provider Business Practice Location Address City Name:
SOUTH PASADENA
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33707-2887
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
727-674-5053
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/15/2006

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: 106H00000X , with the licence number:  MT1677 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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