Healthcare Provider Details

I. General information

NPI: 1871678656
Provider Name (Legal Business Name): ANNA M VARUGHESE M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/27/2006
Last Update Date: 03/09/2022
Certification Date: 03/09/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 6TH AVE S
ST PETERSBURG FL
33701-4634
US

IV. Provider business mailing address

501 6TH AVE S
ST PETERSBURG FL
33701-4634
US

V. Phone/Fax

Practice location:
  • Phone: 727-767-3679
  • Fax: 727-767-8429
Mailing address:
  • Phone: 727-767-3679
  • Fax: 727-767-8429

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207LP3000X
TaxonomyPediatric Anesthesiology Physician
License NumberME138269
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code207LP3000X
TaxonomyPediatric Anesthesiology Physician
License Number35070801
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: