1942560263 NPI number — DR. ARCHIEL BUAGAS-KINTANAR ARNP, PMHNP-BC, NP-C

Table of content: DR. ARCHIEL BUAGAS-KINTANAR ARNP, PMHNP-BC, NP-C (NPI 1942560263)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1942560263 NPI number — DR. ARCHIEL BUAGAS-KINTANAR ARNP, PMHNP-BC, NP-C

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BUAGAS-KINTANAR
Provider First Name:
ARCHIEL
Provider Middle Name:
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
ARNP, PMHNP-BC, NP-C
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
BUAGAS
Provider Other First Name:
ARCHIEL
Provider Other Middle Name:
BAYRON
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1942560263
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/25/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3690 W GANDY BLVD
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:
33611-2608
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
813-513-3599
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1701 MERCY HEALTH PL
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CINCINNATI
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
45237-6147
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
513-853-8520
Provider Business Practice Location Address Fax Number:
513-442-7695
Provider Enumeration Date:
05/21/2012

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: 363LF0000X , with the licence number:  F337183 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363LF0000X , with the licence number: ARNP9366286 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363LF0000X , with the licence number: AP60643395 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363LP0808X , with the licence number: 402123 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363LP0808X , with the licence number: ARNP9366286 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363LP0808X , with the licence number: 0024192200 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363LP0808X , with the licence number: APRN.CNP.0037615 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 013651100 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
  • Identifier: Y0P17 . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 81-3312296 . This is a "AMOMA, LLC" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".