Basic Information
Provider Information
NPI: 1780270157
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: PIGEON
FirstName: ALEXANDRE
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: APRN
OtherOrganizationName:  
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Mailing Information
Address1: 902 E INLET DR
Address2:  
City: MARCO ISLAND
State: FL
PostalCode: 341455913
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 2230 VENETIAN CT STE 1
Address2:  
City: NAPLES
State: FL
PostalCode: 341098727
CountryCode: US
TelephoneNumber: 2392365448
FaxNumber:  
Other Information
ProviderEnumerationDate: 12/18/2020
LastUpdateDate: 12/22/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
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IsSoleProprietor: N
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AuthorizedOfficialCredential:  
NPICertificationDate: 12/22/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LP0808X11010738FLY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsych/Mental Health

No ID Information.


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