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NPI Code Detail

MEDICARE: RUDOLF BIGORD

MEDICARE:   RUDOLF  BIGORD
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
1171M00000XCase Manager/Care Coordinator

General Provider Information

NPI Number : 1417207838
Entity Type Code : Individual
Provider Name (Legal Business Name) : RUDOLF BIGORD
Provider Business Mailing Address
First Line : 1712 ABBEY TRACE DRIVE
Second Line :
City : TAMPA
State : FL
Zip : 33527
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1712 ABBEY TRACE DRIVE
Second Line :
City : TAMPA
State : FL
Zip : 33527
Country : US
Telephone Number : 813-784-7115
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/13/2012
Last Update Date : 09/13/2012

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Directions to “ RUDOLF BIGORD ” Practice Location

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