1730188442 NPI number — DR. MAGDALENA BUGARIN-VIERA M.D.

Table of content: DR. MAGDALENA BUGARIN-VIERA M.D. (NPI 1730188442)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1730188442 NPI number — DR. MAGDALENA BUGARIN-VIERA M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BUGARIN-VIERA
Provider First Name:
MAGDALENA
Provider Middle Name:
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
BUGARIN
Provider Other First Name:
MAGDALENA
Provider Other Middle Name:
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
M.D.
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1730188442
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/11/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 18946
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
TAMPA
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33679-8946
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
813-870-6422
Provider Business Mailing Address Fax Number:
813-870-3421

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4726 N HABANA AVE
Provider Second Line Business Practice Location Address:
SUITE 202
Provider Business Practice Location Address City Name:
TAMPA
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33614-7144
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
813-870-6422
Provider Business Practice Location Address Fax Number:
813-870-3421
Provider Enumeration Date:
07/15/2005

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: 207Q00000X , with the licence number:  ME 67694 , 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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