Provider Demographics
NPI:1285787515
Name:BRIGANTI, MARY WEAVER (DNP, ARNP)
Entity type:Individual
Prefix:DR
First Name:MARY
Middle Name:WEAVER
Last Name:BRIGANTI
Suffix:
Gender:F
Credentials:DNP, ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5785 NEWBURY CIR
Mailing Address - Street 2:
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32940-1884
Mailing Address - Country:US
Mailing Address - Phone:321-698-0308
Mailing Address - Fax:
Practice Address - Street 1:5785 NEWBURY CIR
Practice Address - Street 2:
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32940-1884
Practice Address - Country:US
Practice Address - Phone:321-698-0308
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-19
Last Update Date:2015-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP 3272132363LF0000X
FLARNP3272132363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL003034674Medicaid
FL003034674Medicaid