MEDICARE: JAMES ROY BIGGERSTAFF M.D.

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	207Q00000X	Family Medicine Physician	ME0029200	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	02021	OTHER	FL	BLUE CROSS BLUE SHIELD
2	ME0029200	OTHER	FL	FL LICENSE
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1245239607
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMES ROY BIGGERSTAFF M.D.

Provider Business Mailing Address
First Line	:	601 S HARBOUR ISLAND BLVD STE 200
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33602-5925
Country	:	US
Telephone Number	:	800-480-5243
Fax Number	:	800-928-7449

Provider Business Practice Location Address
First Line	:	2285 KINGSLEY AVE STE E
Second Line	:
City	:	ORANGE PARK
State	:	FL
Zip	:	32073-5133
Country	:	US
Telephone Number	:	904-309-9660
Fax Number	:	844-388-6186

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

Provider Enumeration Date	:	07/19/2005
Last Update Date	:	11/10/2022

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