Bogle, Tanya R.

Bogle, Tanya R. is an individual health care provider with primary practice located at 17645 Jamestown Way , Lutz FL 33558-7706. She recently has 2 registered licenses in different health care specialties including Student, Health Care / Student in an Organized Health Care Education/Training Program, Allopathic & Osteopathic Physicians / Family Medicine. Allopathic & Osteopathic Physicians / Family Medicine is her primary health care specialty. Bogle, Tanya R. can be contacted via phone (423) 718-2698.

Contact Information

Primary practice address
17645 Jamestown Way Lutz FL 33558-7706
Phone: (423) 718-2698
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X ME122205 Florida

Profile Details

NPI number 1316380041
LBN Legal business name Bogle, Tanya R.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 11th, 2013
Last updated Mar 22nd, 2024 - about 9 months 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1316380041 NPPES
Florida MEDICAID 019674600

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