Basic Information
Provider Information
NPI: 1366430274
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BIGLIONE
FirstName: ALEJANDRO
MiddleName: GUSTAVO
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: BIGLIONE
OtherFirstName: ALEX
OtherMiddleName:  
OtherNamePrefix: DR.
OtherNameSuffix:  
OtherCredential: M.D.
OtherLastNameType: 2
Mailing Information
Address1: PO BOX 417
Address2:  
City: STUART
State: FL
PostalCode: 349950417
CountryCode: US
TelephoneNumber: 7722232832
FaxNumber: 7722885834
Practice Location
Address1: 200 SE HOSPITAL AVE
Address2:  
City: STUART
State: FL
PostalCode: 349942346
CountryCode: US
TelephoneNumber: 7722235618
FaxNumber: 7722885834
Other Information
ProviderEnumerationDate: 10/13/2005
LastUpdateDate: 01/31/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000XL3922TXN Allopathic & Osteopathic PhysiciansInternal Medicine 
208M00000XME 78592FLY Allopathic & Osteopathic PhysiciansHospitalist 

ID Information
IDTypeStateIssuerDescription
27662130005FL MEDICAID


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