Provider Demographics
NPI:1659521649
Name:VICTOR BAGA, M.D., P.A.
Entity Type:Organization
Organization Name:VICTOR BAGA, M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:VICTOR
Authorized Official - Middle Name:
Authorized Official - Last Name:BAGA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:941-525-0169
Mailing Address - Street 1:517 RIVIERA ST
Mailing Address - Street 2:UNIT C
Mailing Address - City:VENICE
Mailing Address - State:FL
Mailing Address - Zip Code:34285-2827
Mailing Address - Country:US
Mailing Address - Phone:941-525-0160
Mailing Address - Fax:
Practice Address - Street 1:517 RIVIERA ST
Practice Address - Street 2:UNIT C
Practice Address - City:VENICE
Practice Address - State:FL
Practice Address - Zip Code:34285-2827
Practice Address - Country:US
Practice Address - Phone:941-525-0160
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-25
Last Update Date:2008-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL22039207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty