Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | ME77670 | FL |
Y | 111NI0900X | Internist | ME77670 | FL |
N | 207RA0401X | Internist - Addiction Medicine | ME77670 | FL |
NPI | 1811984818 |
---|---|
Provider Name | Dr. Philip F Bagenski |
First Address | Palm Harbor, FL 34684-3609 |
Second Address | Palm Harbor, FL 34684-3609 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/10/2005 |
Last Update Date | 07/01/2016 |