MEDICARE: DOUGLAS P. NAGLE P.A.

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	363A00000X	Physician Assistant	PA2786	FL

General Provider Information

NPI Number	:	1043284680
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DOUGLAS P. NAGLE P.A.

Provider Business Mailing Address
First Line	:	6804 CECELIA DR
Second Line	:
City	:	NEW PORT RICHEY
State	:	FL
Zip	:	34653-4935
Country	:	US
Telephone Number	:	727-232-0644
Fax Number	:	888-546-0488

Provider Business Practice Location Address
First Line	:	6804 CECELIA DR
Second Line	:
City	:	NEW PORT RICHEY
State	:	FL
Zip	:	34653-4935
Country	:	US
Telephone Number	:	727-232-0644
Fax Number	:	888-546-0488

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

Provider Enumeration Date	:	02/13/2006
Last Update Date	:	04/14/2022

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