Provider Demographics
NPI:1003876756
Name:NAGIBINA, TATIANA P (MD)
Entity Type:Individual
Prefix:DR
First Name:TATIANA
Middle Name:P
Last Name:NAGIBINA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32615 US HIGHWAY 19 N STE 2
Mailing Address - Street 2:
Mailing Address - City:PALM HARBOR
Mailing Address - State:FL
Mailing Address - Zip Code:34684-3176
Mailing Address - Country:US
Mailing Address - Phone:727-789-2784
Mailing Address - Fax:727-785-3537
Practice Address - Street 1:32615 US HIGHWAY 19 N
Practice Address - Street 2:SUITE 2
Practice Address - City:PALM HARBOR
Practice Address - State:FL
Practice Address - Zip Code:34684-3176
Practice Address - Country:US
Practice Address - Phone:727-789-2784
Practice Address - Fax:727-785-3537
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-26
Last Update Date:2013-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME81965207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
K3928OtherPTAN
K3928OtherPTAN