Provider Demographics
NPI:1275774036
Name:BEGANOVIC, EDINA
Entity Type:Individual
Prefix:
First Name:EDINA
Middle Name:
Last Name:BEGANOVIC
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3074 HIGHLAND ST N
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33704-2029
Mailing Address - Country:US
Mailing Address - Phone:727-892-9912
Mailing Address - Fax:
Practice Address - Street 1:3074 HIGHLAND ST N
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33704-2029
Practice Address - Country:US
Practice Address - Phone:727-892-9912
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-03-09
Last Update Date:2009-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health