Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | ME92329 | FL |
N | 208600000X | Surgeon | ME92329 | FL |
Y | 2086S0102X | Surgical Critical Care | ME92329 | FL |
NPI | 1013960095 |
---|---|
Provider Name | Dr. Elizabeth Patricia Bugarin |
First Address | Orlando, FL 32803-1248 |
Second Address | Orlando, FL 32803-1248 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/05/2006 |
Last Update Date | 16/03/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01033 | BLUE CROSS BLUE SHIELD (01) | FL |
272858300 | (05) | FL |
H61503 | (02) | FL |