Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RR0500X | Rheumatology | ME81965 | FL |
NPI | 1003876756 |
---|---|
Provider Name | Dr. Tatiana P. Nagibina |
First Address | Palm Harbor, FL 34684-3176 |
Second Address | Palm Harbor, FL 34684-3176 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/03/2006 |
Last Update Date | 03/01/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H45956 | (02) | FL |
K3928 | PTAN (01) |