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NPI Code Detail

MEDICARE: MELODY S AGBUNAG M.D.

MEDICARE: MELODY S AGBUNAG M.D.
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
12084P0800XPsychiatry PhysicianME42069FL
22084P0804XChild & Adolescent Psychiatry PhysicianM342069FL

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 : 1467558593
Entity Type Code : Individual
Provider Name (Legal Business Name) : MELODY S AGBUNAG M.D.
Provider Business Mailing Address
First Line : 2634 CAPITAL CIR NE
Second Line :
City : TALLAHASSEE
State : FL
Zip : 32308-4106
Country : US
Telephone Number : 850-523-3333
Fax Number : 850-523-3411
Provider Business Practice Location Address
First Line : 2634 CAPITAL CIR NE
Second Line :
City : TALLAHASSEE
State : FL
Zip : 32308-4106
Country : US
Telephone Number : 850-523-3333
Fax Number : 850-523-3411
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/16/2006
Last Update Date : 02/19/2009

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