Healthcare Provider Details

I. General information

NPI: 1932498573
Provider Name (Legal Business Name): DAVID NIGEN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/05/2011
Last Update Date: 11/18/2024
Certification Date: 11/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6333 N FEDERAL HWY STE 250
FORT LAUDERDALE FL
33308
US

IV. Provider business mailing address

1700 NW 49TH ST STE 125
FT LAUDERDALE FL
33309-3750
US

V. Phone/Fax

Practice location:
  • Phone: 954-776-8580
  • Fax: 954-776-8588
Mailing address:
  • Phone: 954-776-8580
  • Fax: 954-776-8588

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberME146097
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code207XX0005X
TaxonomySports Medicine (Orthopaedic Surgery) Physician
License NumberME146097
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: