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General NPI Number Information
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NPI Number | 1699854562
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Entity Type | Individual
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Provider Name | MICHAEL JOHN LIGOTTI DO
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Gender | Male
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Dates
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Enumeration Date | 11/03/2006
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Last Update Date | 06/01/2016
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Provider Practice Location Address
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Address Line | 402 SE 6TH AVE
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City | DELRAY BEACH
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State | FL
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Zip | 33483-5231
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Country | US
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Telephone | 561-265-1990
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Fax | 561-330-9011
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Provider Business Mailing Address
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Address Line | PO BOX 832078
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City | DELRAY BEACH
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State | FL
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Zip | 33483-0278
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Country | US
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Telephone | 561-265-1990
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Fax | 561-330-9011
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | OS9035
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 207RA0401X
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Taxonomy Name | Addiction Medicine (Internal Medicine) Physician
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License Number | OS9035
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License Number State | FL
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