MEDICARE: DR. SETH TA'AGAMANUSINA PURCELL MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208600000X	Surgery Physician	R3188	TX
2	2086S0129X	Vascular Surgery Physician	ME153952	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1144587841
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SETH TA'AGAMANUSINA PURCELL MD

Provider Business Mailing Address
First Line	:	10441 QUALITY DR STE 205
Second Line	:
City	:	SPRING HILL
State	:	FL
Zip	:	34609-9652
Country	:	US
Telephone Number	:	801-472-3563
Fax Number	:	727-755-0926

Provider Business Practice Location Address
First Line	:	10441 QUALITY DR STE 205
Second Line	:
City	:	SPRING HILL
State	:	FL
Zip	:	34609-9652
Country	:	US
Telephone Number	:	352-770-8346
Fax Number	:	727-755-0926

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/18/2012
Last Update Date	:	06/14/2022

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