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General NPI Number Information
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NPI Number | 1447872122
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Entity Type | Organization
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Legal Business Name | HOME DOCTOR NETWORK, LLC
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Dates
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Enumeration Date | 05/15/2020
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Last Update Date | 11/05/2020
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Provider Practice Location Address
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Address Line | 5260 78TH AVE N UNIT 1562
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City | PINELLAS PARK
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State | FL
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Zip | 33780-8062
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Country | US
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Telephone | 727-415-2308
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Fax |
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Provider Business Mailing Address
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Address Line | 5260 78TH AVE N UNIT 1562
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City | PINELLAS PARK
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State | FL
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Zip | 33780-8062
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Country | US
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Telephone | 727-415-2308
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Fax |
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Authorized Official
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Title or Position | AUTHORIZED MEMBER
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Name | MICHAEL PAUL BAGBY
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Credential |
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Telephone | 727-415-2308
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133NN1002X
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Taxonomy Name | Nutrition Education Nutritionist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 170100000X
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Taxonomy Name | Ph.D. Medical Genetics
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 170300000X
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Taxonomy Name | Genetic Counselor (M.S.)
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 174H00000X
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Taxonomy Name | Health Educator
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 202K00000X
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Taxonomy Name | Phlebology Physician
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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Taxonomy #8
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Taxonomy Code | 332BD1200X
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Taxonomy Name | Dialysis Equipment & Supplies (DME)
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License Number |
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License Number State |
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Taxonomy #9
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Taxonomy Code | 332BX2000X
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Taxonomy Name | Oxygen Equipment & Supplies (DME)
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License Number |
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License Number State |
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Taxonomy #10
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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