Samuel Agresta MD
Internal Medicine Physician in Tampa, FL(View on Map)
Full Name
Samuel Agresta MD
NPI Number
1043251457
NPI Type
Individual Provider
Gender
Male
Enumeration Date
06/09/2006
Specialties
(Taxonomies)Code
207R00000X
207RH0003X
Primary Taxonomy
Yes
No
Licenses
State
Florida
License Number
ME96014
Contact
Information
Purpose
Mailing
Location
Address
PO BOX 917770
12902 MAGNOLIA DR
City
Orlando
Tampa
State
FL
FL
Postal Code
32891-7770
33612-9416
Country
US
US
Telephone Number
N/A
(813) 745-5768
Identifiers
Identifier
54281
Identifier State
FL
Identifier Issuer
BLUE CROSS BLUE SHIELD
Provider data last refreshed from NPPES NPI registry on 11/19/2024
Data last updated by provider on 01/15/2008
Provider Address
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