Individual
AGNES V NALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
701 MANATEE AVE W, SUITE 202, BRADENTON, FL 34205-8604
(941) 748-2455
(941) 746-4554
Mailing address
701 MANATEE AVE W, SUITE 202, BRADENTON, FL 34205-8604
(941) 748-2455
(941) 746-4554
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
ME0062805
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
32543
BCBS PROVIDER NUMBER
FL
01
—
923602
AETNA PROVIDER NUMBER
FL
Enumeration date
07/15/2005
Last updated
09/09/2024
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