Bagenholm, Bo
Bagenholm, Bo is an sole proprietor health care provider with primary practice located at 1704 Duffy Loop , The Villages FL 32162-4093. He recently has only one registered license in Allopathic & Osteopathic Physicians / Gynecology, which is considered as his primary health care specialty. Bagenholm, Bo can be contacted via phone (352) 350-2530.Contact Information
Primary practice address
1704 Duffy Loop
The Villages FL 32162-4093
Phone: (352) 350-2530
Fax: (352) 350-2530
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Gynecology | 207VG0400X | ME24950 | Florida |
Profile Details
| NPI number | 1548566904 |
|---|---|
| LBN Legal business name | Bagenholm, Bo |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Feb 2nd, 2011 |
| Last updated | Feb 2nd, 2011 - about 14 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 | 1548566904 | NPPES |
| Florida | MEDICAID | 50474-2 |
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