Healthcare Provider Details

I. General information

NPI: 1184566630
Provider Name (Legal Business Name): KARINA BAGDASAROVA NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/06/2026
Last Update Date: 04/06/2026
Certification Date: 04/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2350 BOTANICA LN
PEPPER PIKE OH
44124-5669
US

IV. Provider business mailing address

2350 BOTANICA LN
PEPPER PIKE OH
44124-5669
US

V. Phone/Fax

Practice location:
  • Phone: 216-356-1575
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number0041929
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: