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NPI Code Detail

MEDICARE: MICHAEL ANDREW LIGMANOWSKI ATC

MEDICARE: MICHAEL ANDREW LIGMANOWSKI ATC
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
12255A2300XAthletic TrainerAL2811FL

General Provider Information

NPI Number : 1861716565
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHAEL ANDREW LIGMANOWSKI ATC
Provider Business Mailing Address
First Line : 1924 MELROSE PLANTATION DR
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32223-5545
Country : US
Telephone Number : 904-880-5992
Fax Number :
Provider Business Practice Location Address
First Line : 6248 103RD ST
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32210-7733
Country : US
Telephone Number : 904-573-0046
Fax Number : 904-573-0772
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/24/2010
Last Update Date : 03/24/2010

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