Provider Demographics
NPI:1821129149
Name:VARGAS BEJARANO, MONICA (MD)
Entity Type:Individual
Prefix:DR
First Name:MONICA
Middle Name:
Last Name:VARGAS BEJARANO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:MONICA
Other - Middle Name:
Other - Last Name:BEJARANO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:1988 GULF TO BAY BLVD STE 1
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33765-3550
Mailing Address - Country:US
Mailing Address - Phone:727-953-8090
Mailing Address - Fax:727-953-8088
Practice Address - Street 1:1988 GULF TO BAY BLVD SUITE 1
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33765
Practice Address - Country:US
Practice Address - Phone:727-953-8090
Practice Address - Fax:727-953-8088
Is Sole Proprietor?:No
Enumeration Date:2007-03-08
Last Update Date:2018-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME94182174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLME94182OtherMEDICAL LICENSE
FLU5841Y W/GROUP 34259Medicare PIN
FLU5841X W/GROUP34259AMedicare PIN