Fagaragan, Mary L
Fagaragan, Mary L is an individual health care provider with primary practice located at 687 Beville Rd Ste A , South Daytona FL 32119-1970. She recently has only one registered license in Other Service Providers / Case Manager/Care Coordinator, which is considered as her primary health care specialty. Fagaragan, Mary L can be contacted via phone (386) 871-4781.Contact Information
Primary practice address
687 Beville Rd Ste A
South Daytona FL 32119-1970
Phone: (386) 871-4781
Fax: (386) 761-5868
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Case Manager/Care Coordinator | 171M00000X |
Profile Details
| NPI number | 1083265995 |
|---|---|
| LBN Legal business name | Fagaragan, Mary L |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 23rd, 2019 |
| Last updated | Dec 14th, 2023 - about last year |
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 | 1083265995 | NPPES |
| Florida | MEDICAID | 104854300 |
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