Provider Demographics
NPI:1194708172
Name:BRIGGS, JOHN DAVID (MD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:DAVID
Last Name:BRIGGS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:660 GLADES RD
Mailing Address - Street 2:SUITE 340
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33431-6465
Mailing Address - Country:US
Mailing Address - Phone:561-394-9292
Mailing Address - Fax:561-394-3819
Practice Address - Street 1:660 GLADES RD
Practice Address - Street 2:SUITE 340
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33431-6465
Practice Address - Country:US
Practice Address - Phone:561-394-9292
Practice Address - Fax:561-394-3819
Is Sole Proprietor?:No
Enumeration Date:2005-11-23
Last Update Date:2008-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME43034174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL047756700Medicaid
FL047756700Medicaid
FL61504Medicare ID - Type Unspecified