MEDICARE: KRISTOFER BRIAN AIGNER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YA0400X	Addiction (Substance Use Disorder) Counselor	CAP.0100663	FL

General Provider Information

NPI Number	:	1053266072
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KRISTOFER BRIAN AIGNER

Provider Business Mailing Address
First Line	:	215 S OCEAN GRANDE DR
Second Line	:
City	:	PONTE VEDRA BEACH
State	:	FL
Zip	:	32082-4589
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	215 S OCEAN GRANDE DR
Second Line	:
City	:	PONTE VEDRA BEACH
State	:	FL
Zip	:	32082-4589
Country	:	US
Telephone Number	:	203-895-2820
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/04/2026
Last Update Date	:	03/04/2026

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Directions to “ KRISTOFER BRIAN AIGNER ” Practice Location

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