| Jennifer Bagwell Llc | |
|
4440 Pga Blvd Ste 202 Palm Beach Gardens FL 33410-6540 | |
| (954) 465-6988 | |
| (561) 249-3709 |
| Full Name | Jennifer Bagwell Llc |
|---|---|
| Speciality | Social Worker |
| Location | 4440 Pga Blvd Ste 202, Palm Beach Gardens, Florida |
| Authorized Official Name and Position | Jennifer M Bagwell (OWNER) |
| Authorized Official Contact | 9544656988 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jennifer Bagwell Llc 7511 Ladson Ter Lake Worth FL 33467-7725 Ph: (954) 465-6988 | Jennifer Bagwell Llc 4440 Pga Blvd Ste 202 Palm Beach Gardens FL 33410-6540 Ph: (954) 465-6988 |
| NPI Number | 1760997787 |
|---|---|
| Provider Enumeration Date | 12/13/2017 |
| Last Update Date | 12/13/2017 |
| Medicare PECOS PAC ID | 2466706510 |
|---|---|
| Medicare Enrollment ID | O20181108002194 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760997787 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | SW6366 (Florida) | Primary |
| Provider Name | Jennifer M Bagwell |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1790994598 PECOS PAC ID: 6800140955 Enrollment ID: I20181108002440 |
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