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Organization

MY TELEVISIT MD LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. MICHAEL PAUL BAGBY (CEO/AMBR)
(727) 415-2308
Entity
Organization

Contact information

Practice address
5560 ROOSEVELT BOULEVARD, SUITE 4 #50, CLEARWATER, FL 33760
(727) 415-2308
Mailing address
5560 ROOSEVELT BOULEVARD, SUITE 4 #50, CLEARWATER, FL 33760-9228
(727) 415-2308

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
133NN1002X
Nutrition Education Nutritionist
163WH0200X
Home Health Registered Nurse
171M00000X
Case Manager/Care Coordinator
Primary
2083P0901X
Public Health & General Preventive Medicine Physician
208D00000X
General Practice Physician
261Q00000X
Clinic/Center
261QR0800X
Recovery Care Clinic/Center
261QR1300X
Rural Health Clinic/Center
374U00000X
Home Health Aide

Other

Enumeration date
03/28/2024
Last updated
03/28/2024
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