1861634537 NPI number — MRS. TANIA CRISTINA VARGAS M.S.

Table of content: MRS. TANIA CRISTINA VARGAS M.S. (NPI 1861634537)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1861634537 NPI number — MRS. TANIA CRISTINA VARGAS M.S.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
VARGAS
Provider First Name:
TANIA
Provider Middle Name:
CRISTINA
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
M.S.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
CANTYMAGLI
Provider Other First Name:
TANIA
Provider Other Middle Name:
CRISTINA
Provider Other Name Prefix Text:
MISS
Provider Other Name Suffix Text:
Provider Other Credential Text:
B.S.
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1861634537
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/11/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
492 WESTFORD CIR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PALM HARBOR
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
34683-6134
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
813-451-3354
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4223 W SAN LUIS ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
TAMPA
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33629-7717
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
727-560-2207
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/27/2009

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: 235Z00000X , with the licence number:  SA11457 , 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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