Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | OS9035 | FL |
Y | 207RA0401X | Internist - Addiction Medicine | OS9035 | FL |
NPI | 1699854562 |
---|---|
Provider Name | Mr. Michael John Ligotti |
First Address | Delray Beach, FL 33483-0278 |
Second Address | Delray Beach, FL 33483-5231 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/11/2006 |
Last Update Date | 01/06/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
I43512 | (02) | FL |