Healthcare Provider Details

I. General information

NPI: 1780270157
Provider Name (Legal Business Name): ALEXANDRE PIGEON APRN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/18/2020
Last Update Date: 12/22/2021
Certification Date: 12/22/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2230 VENETIAN CT STE 1
NAPLES FL
34109-8727
US

IV. Provider business mailing address

902 E INLET DR
MARCO ISLAND FL
34145-5913
US

V. Phone/Fax

Practice location:
  • Phone: 239-236-5448
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number11010738
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: