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Organization

HOME DOCTOR NETWORK, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MICHAEL PAUL BAGBY (AUTHORIZED MEMBER)
(727) 415-2308
Entity
Organization

Contact information

Practice address
5260 78TH AVE N UNIT 1562, PINELLAS PARK, FL 33780-8062
(727) 415-2308
Mailing address
5260 78TH AVE N UNIT 1562, PINELLAS PARK, FL 33780-8062
(727) 415-2308

Taxonomy

Speciality
Code
Description
License number
State
133NN1002X
Nutrition Education Nutritionist
170100000X
Ph.D. Medical Genetics
170300000X
Genetic Counselor (M.S.)
174H00000X
Health Educator
202K00000X
Phlebology Physician
251B00000X
Case Management Agency
Primary
251E00000X
Home Health Agency
332B00000X
Durable Medical Equipment & Medical Supplies
332BD1200X
Dialysis Equipment & Supplies (DME)
332BX2000X
Oxygen Equipment & Supplies (DME)

Other

Enumeration date
05/15/2020
Last updated
11/05/2020
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