Provider Demographics
NPI:1811925191
Name:PAGLIA, ANTHONY LOUIS (MD)
Entity type:Individual
Prefix:
First Name:ANTHONY
Middle Name:LOUIS
Last Name:PAGLIA
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 1:21110 BISCAYNE BLVD STE 205
Mailing Address - Street 2:
Mailing Address - City:AVENTURA
Mailing Address - State:FL
Mailing Address - Zip Code:33180-1251
Mailing Address - Country:US
Mailing Address - Phone:954-458-1199
Mailing Address - Fax:954-458-1833
Practice Address - Street 1:21110 BISCAYNE BLVD STE 205
Practice Address - Street 2:
Practice Address - City:AVENTURA
Practice Address - State:FL
Practice Address - Zip Code:33180-1251
Practice Address - Country:US
Practice Address - Phone:954-458-1199
Practice Address - Fax:954-458-1833
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-28
Last Update Date:2020-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL0068173208VP0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL27441OtherBCBS FL
FL378842300Medicaid
FL917266600OtherCIGNA
FL650904466OtherHUMANA
FL378842300Medicaid
FL917266600OtherCIGNA