Healthcare Provider Details

I. General information

NPI: 1043129885
Provider Name (Legal Business Name): MARIA FERNANDA BAGNASCO PHC-NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/07/2026
Last Update Date: 09/07/2026
Certification Date: 09/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15 RICHARDSON STREET APT 1402
TORONTO CANADA
M5A 0Y5
CA

IV. Provider business mailing address

15 RICHARDSON STREET APT 1402
TORONTO CANADA
M5A 0Y5
CA

V. Phone/Fax

Practice location:
  • Phone:
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN11047725
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: