Healthcare Provider Details

I. General information

NPI: 1790724698
Provider Name (Legal Business Name): TERESA A PIGOTT MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: TERESA A PIGOTT

II. Dates (important events)

Enumeration Date: 06/06/2006
Last Update Date: 03/06/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 SW ARCHER RD BOX 100371
GAINESVILLE FL
32610-3003
US

IV. Provider business mailing address

PO BOX 918025
ORLANDO FL
32891-8025
US

V. Phone/Fax

Practice location:
  • Phone: 352-392-3681
  • Fax: 352-392-2579
Mailing address:
  • Phone: 352-392-3681
  • Fax: 352-392-2579

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberME83688
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: