MEDICARE: PETER J RIGGS PA

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	363A00000X	Physician Assistant	PA3598	FL

General Provider Information

NPI Number	:	1255336574
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PETER J RIGGS PA

Provider Business Mailing Address
First Line	:	1325 SAN MARCO BLVD
Second Line	:	SUITE 701
City	:	JACKSONVILLE
State	:	FL
Zip	:	32207-8568
Country	:	US
Telephone Number	:	904-858-6418
Fax Number	:	904-858-6490

Provider Business Practice Location Address
First Line	:	1801 BARRS ST
Second Line	:	# 300
City	:	JACKSONVILLE
State	:	FL
Zip	:	32204-4732
Country	:	US
Telephone Number	:	904-388-1400
Fax Number	:	904-389-3205

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

Provider Enumeration Date	:	06/14/2005
Last Update Date	:	07/08/2007

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Directions to “ PETER J RIGGS PA” Practice Location

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