Brian D Ridgely in Port St Lucie - Physician Assistant
Brian D Ridgely - NPI 1326062977
Brian D Ridgely is a Physician Assistant in Port St Lucie, Florida. Brian D Ridgely practices all healthcare services and medical treatments related to Physician Assistant. The NPI Number for Brian D Ridgely is 1326062977. The last update date is 2010-06-15.
Brian D Ridgely's current location address is 1651 Se Tiffany Ave, Port St Lucie, Florida. You can contact this provider via phone number 7723981800 and fax number 7723981815. The mailing address for Brian D Ridgely is 1651 Se Tiffany Ave, Port St Lucie, Florida. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Brian D Ridgely |
|---|---|
| Address | 1651 Se Tiffany Ave, Port St Lucie, Florida |
| Phone Number | 7723981800 |
| Fax Number | 7723981815 |
| Sole Proprietor | N |
| Credentials | PA |
NPI Number Detail
| NPI Number | 1326062977 |
|---|---|
| Provider Enumeration Date | 2006-07-27 |
| Last Updated Date | 2010-06-15 |
Provider Mailing Address Detail
| Address | 1651 Se Tiffany Ave |
|---|---|
| City | Port St Lucie |
| State | Florida (FL) |
| Post Code | 349527564 |
| Phone Number | 7723981800 |
| Fax Number | 7723981815 |
Provider's Primary Taxonomy Detail
| Speciality | Physician Assistant |
|---|---|
| Taxonomy | 363A00000X |
| Licence No | PA3524 |
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Definition: A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perfor |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 290394600 | FL | -- |
Post Comment/ Review Below
What is the Brian D Ridgely's 1326062977?
The Brian D Ridgely's NPI (National Provider Identifier) Number is 1326062977. This unique 10-digit identification number is assigned to health care providers by the Centers for Medicare & Medicaid Services (CMS).
Can you provide the Brian D Ridgely's physical address?
The Brian D Ridgely is physically located at 1651 Se Tiffany Ave, in the city of Port St Lucie, FL, with the postal code 349527564.
What is the Brian D Ridgely's area of specialization and corresponding taxonomy classification?
The Brian D Ridgely's specialty field is Physician Assistant, and it falls under the taxonomy code 363A00000X, which categorizes healthcare providers based on their specialties.
On what date did the Brian D Ridgely receive the assignment of its 1326062977 from the Centers for Medicare & Medicaid Services?
The Brian D Ridgely was issued its 1326062977 by the Centers for Medicare & Medicaid Services on 2006-07-27.
As of what date were the Brian D Ridgely's details last updated?
The information pertaining to the Brian D Ridgely, including its address, specialty, and other details, was most recently updated on 2010-06-15.