Healthcare Provider Details

I. General information

NPI: 1831471069
Provider Name (Legal Business Name): DAVID A. SIGALOW, MD, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/14/2011
Last Update Date: 09/14/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

215 NE 19TH DR
OKEECHOBEE FL
34972-1933
US

IV. Provider business mailing address

215 NE 19TH DR
OKEECHOBEE FL
34972-1933
US

V. Phone/Fax

Practice location:
  • Phone: 863-763-0217
  • Fax: 863-467-5148
Mailing address:
  • Phone: 863-763-0217
  • Fax: 863-467-5148

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number0062053
License Number StateFL

VIII. Authorized Official

Name: DR. DAVID A SIGALOW
Title or Position: MEDICAL DOCTOR
Credential: M.D., P.A.
Phone: 863-763-0217