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NPI Code Detail

MEDICARE: MR. MICHAEL JOHN LIGOTTI DO

MEDICARE: MR. MICHAEL JOHN LIGOTTI DO
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
1207Q00000XFamily Medicine PhysicianOS9035FL
2207RA0401XAddiction Medicine (Internal Medicine) PhysicianOS9035FL

General Provider Information

NPI Number : 1699854562
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. MICHAEL JOHN LIGOTTI DO
Provider Business Mailing Address
First Line : PO BOX 832078
Second Line :
City : DELRAY BEACH
State : FL
Zip : 33483-0278
Country : US
Telephone Number : 561-265-1990
Fax Number : 561-330-9011
Provider Business Practice Location Address
First Line : 402 SE 6TH AVE
Second Line :
City : DELRAY BEACH
State : FL
Zip : 33483-5231
Country : US
Telephone Number : 561-265-1990
Fax Number : 561-330-9011
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/03/2006
Last Update Date : 06/01/2016

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Directions to “ MR. MICHAEL JOHN LIGOTTI DO” Practice Location

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