MEDICARE: DR. CLAUDIA P VERGARA D.S.S

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
1	1223G0001X	General Practice Dentistry	DN 15886	FL

General Provider Information

NPI Number	:	1043266505
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CLAUDIA P VERGARA D.S.S

Provider Business Mailing Address
First Line	:	12025 ROYCE WATERFORD CIR
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33626-3315
Country	:	US
Telephone Number	:	813-926-3066
Fax Number	:

Provider Business Practice Location Address
First Line	:	8573 W LINEBAUGH AVE
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33625-3731
Country	:	US
Telephone Number	:	813-852-2007
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/26/2006
Last Update Date	:	07/08/2007

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