Organization
NICHOLAS G. BAGNOLI DO PA
Active
Parent organization
NICHOLAS G, BAGNOLI DO PA
Organization subpart
Yes
Provider details
NPI number
Legal business name
NICHOLAS G, BAGNOLI DO PA
Authorized official
DR. NICHOLAS G BAGNOLI MD (OWNER)
(407) 210-4251
Entity
Organization
Contact information
Practice address
1220 SLIGH BLVD, ORLANDO, FL 32806-1108
(407) 210-4251
(407) 648-0968
Mailing address
3869 WINDERLAKES DR, ORLANDO, FL 32835-2625
(407) 210-4251
(407) 648-0968
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
252446500
—
FL
Enumeration date
02/04/2010
Last updated
03/25/2010
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