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NPI Code Detail

MEDICARE: TYNA L BAUGESS CAP

MEDICARE: TYNA L BAUGESS CAP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101Y00000XCounselor5629FL
2101YA0400XAddiction (Substance Use Disorder) Counselor081148OH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1033455662
Entity Type Code : Individual
Provider Name (Legal Business Name) : TYNA L BAUGESS CAP
Provider Business Mailing Address
First Line : 1766 SOPHIAS DR APT 202
Second Line :
City : MELBOURNE
State : FL
Zip : 32940-6211
Country : US
Telephone Number : 614-271-3474
Fax Number :
Provider Business Practice Location Address
First Line : 3157 N ALAFAYA TRL
Second Line :
City : ORLANDO
State : FL
Zip : 32826-2940
Country : US
Telephone Number : 407-215-0095
Fax Number : 407-261-0523
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/01/2013
Last Update Date : 03/14/2016

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