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General NPI Number Information
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NPI Number | 1164096871
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Entity Type | Individual
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Provider Name | MICHAEL ANTHONY TIGELEIRO PA-C
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Gender | Male
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Dates
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Enumeration Date | 05/17/2021
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Last Update Date | 08/15/2022
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Provider Practice Location Address
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Address Line | 8130 LAKEWOOD MAIN ST STE 103
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City | LAKEWOOD RANCH
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State | FL
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Zip | 34202-5068
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Country | US
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Telephone | 941-499-2700
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Fax |
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Provider Business Mailing Address
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Address Line | 3633 PARKRIDGE CIR
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City | SARASOTA
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State | FL
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Zip | 34243-1446
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Country | US
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Telephone | 561-766-3982
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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