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NPI Code Detail

MEDICARE: DR. MICHAEL JOSEPH BAGLINO D.O.

MEDICARE: DR. MICHAEL JOSEPH BAGLINO D.O.
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
1204D00000XNeuromusculoskeletal Medicine & OMM PhysicianOS8512FL
2207Q00000XFamily Medicine PhysicianOS 8512FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
181349OTHERFLBLUE CROSS BLUE SHIELD

General Provider Information

NPI Number : 1780735050
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MICHAEL JOSEPH BAGLINO D.O.
Provider Business Mailing Address
First Line : PO BOX 1239
Second Line :
City : TROY
State : MI
Zip : 48099-1239
Country : US
Telephone Number : 248-824-6600
Fax Number : 248-324-1477
Provider Business Practice Location Address
First Line : 4348 SOUTHPOINT BLVD
Second Line : SUITE 100
City : JACKSONVILLE
State : FL
Zip : 32216-0903
Country : US
Telephone Number : 904-281-1915
Fax Number : 904-281-1119
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/15/2007
Last Update Date : 09/10/2013

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