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General NPI Number Information
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NPI Number | 1891289732
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Entity Type | Individual
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Provider Name | TOMMASO VAGAGGINI MD
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Gender | Male
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Dates
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Enumeration Date | 06/14/2018
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Last Update Date | 11/13/2024
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Provider Practice Location Address
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Address Line | 3601 W 76TH ST STE 300
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City | EDINA
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State | MN
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Zip | 55435-6215
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Country | US
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Telephone | 952-929-1131
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Fax |
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Provider Business Mailing Address
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Address Line | 270 HENNEPIN AVE APT 1624
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City | MINNEAPOLIS
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State | MN
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Zip | 55401-7537
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Country | US
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Telephone | 917-302-0871
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207WX0107X
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Taxonomy Name | Retina Specialist (Ophthalmology) Physician
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License Number | 71837
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License Number State | MN
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