Agerton, Colin D
Agerton, Colin D is an individual health care provider with primary practice located at 6117 Gunn Hwy , Tampa FL 33625-4013. He recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Medical, Physician Assistants & Advanced Practice Nursing Providers / Surgical. Physician Assistants & Advanced Practice Nursing Providers / Medical is his primary health care specialty. Agerton, Colin D can be contacted via phone (813) 978-9700.Contact Information
Primary practice address
6117 Gunn Hwy
Tampa FL 33625-4013
Phone: (813) 978-9700
Fax: (813) 558-6187
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Medical | 363AM0700X | PA9105738 | Florida |
| Physician Assistants & Advanced Practice Nursing Providers / Surgical | 363AS0400X | PA9105738 | Florida |
Profile Details
| NPI number | 1245540632 |
|---|---|
| LBN Legal business name | Agerton, Colin D |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 19th, 2010 |
| Last updated | Jun 29th, 2015 - about 9 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1245540632 | NPPES |
| Florida | Other | Y09H3 | BCBS |
| Florida | Other | PA9105738 | BCBS |
| Florida | MEDICAID | 004380300 | BCBS |
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