Provider Demographics
NPI:1720360951
Name:BAGINSKI, JOLANTA L (ARNP)
Entity Type:Individual
Prefix:MS
First Name:JOLANTA
Middle Name:L
Last Name:BAGINSKI
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 10744
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33757-8744
Mailing Address - Country:US
Mailing Address - Phone:727-532-0002
Mailing Address - Fax:727-266-4928
Practice Address - Street 1:400 PINELLAS ST
Practice Address - Street 2:SUITE 200
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33756-3312
Practice Address - Country:US
Practice Address - Phone:727-462-2131
Practice Address - Fax:727-266-4914
Is Sole Proprietor?:No
Enumeration Date:2011-09-14
Last Update Date:2015-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP3165382363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL004121300Medicaid
FL004121300Medicaid
FLFK578WMedicare PIN
FLFK578ZMedicare PIN
FLFK578XMedicare PIN