Provider Demographics
NPI:1669419248
Name:BOGGUS, DAN ARGIN (MD)
Entity type:Individual
Prefix:
First Name:DAN
Middle Name:ARGIN
Last Name:BOGGUS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1755 DAVID WALKER DR
Mailing Address - Street 2:
Mailing Address - City:TAVARES
Mailing Address - State:FL
Mailing Address - Zip Code:32778-5745
Mailing Address - Country:US
Mailing Address - Phone:352-742-8830
Mailing Address - Fax:352-742-8826
Practice Address - Street 1:1755 DAVID WALKER DR
Practice Address - Street 2:
Practice Address - City:TAVARES
Practice Address - State:FL
Practice Address - Zip Code:32778-5745
Practice Address - Country:US
Practice Address - Phone:352-742-8830
Practice Address - Fax:352-742-8826
Is Sole Proprietor?:No
Enumeration Date:2006-06-01
Last Update Date:2007-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME42891207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL35208OtherBCBS
FL35208XMedicare PIN
D54364Medicare UPIN