Individual
DR. STEPHEN BAGNOLI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3599 UNIVERSITY BLVD S, SUITE 901, JACKSONVILLE, FL 32216-4252
(904) 398-6971
(904) 398-2497
Mailing address
3599 UNIVERSITY BLVD S, SUITE 901, JACKSONVILLE, FL 32216-4252
(904) 398-6971
(904) 398-2497
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
ME0045005
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036050300
—
FL
Enumeration date
07/31/2005
Last updated
04/08/2014
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