Provider Demographics
NPI:1639984800
Name:BAGGINI, ANGEL JR
Entity type:Individual
Prefix:MR
First Name:ANGEL
Middle Name:
Last Name:BAGGINI
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11505 N PASEO ALEJANDRO
Mailing Address - Street 2:
Mailing Address - City:MARANA
Mailing Address - State:AZ
Mailing Address - Zip Code:85653-8704
Mailing Address - Country:US
Mailing Address - Phone:520-405-0031
Mailing Address - Fax:
Practice Address - Street 1:3323 N CAMPBELL AVE STE 2
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85719-2360
Practice Address - Country:US
Practice Address - Phone:520-882-3309
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-12
Last Update Date:2025-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZMT-10813225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist