Healthcare Provider Details

I. General information

NPI: 1912818931
Provider Name (Legal Business Name): BAGLIETTO MEDICAL GROUP LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/16/2026
Last Update Date: 09/16/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18505 NW 75TH PL STE 106
HIALEAH FL
33015-2961
US

IV. Provider business mailing address

18505 NW 75TH PL STE 106
HIALEAH FL
33015-2961
US

V. Phone/Fax

Practice location:
  • Phone: 305-456-5029
  • Fax: 786-438-5006
Mailing address:
  • Phone: 305-456-5029
  • Fax: 786-438-5006

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: ALBA BAGLIETTO
Title or Position: APRN
Credential: APRN
Phone: 305-456-5029