Provider Demographics
NPI:1528276086
Name:RIGGS, CHARLES E JR (MD)
Entity type:Individual
Prefix:
First Name:CHARLES
Middle Name:E
Last Name:RIGGS
Suffix:JR
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:PO BOX 918025
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32891-8025
Mailing Address - Country:US
Mailing Address - Phone:352-273-7822
Mailing Address - Fax:352-273-5006
Practice Address - Street 1:1600 SW ARCHER RD
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32610-3003
Practice Address - Country:US
Practice Address - Phone:352-273-7822
Practice Address - Fax:352-273-5006
Is Sole Proprietor?:No
Enumeration Date:2007-05-18
Last Update Date:2012-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0084258207RH0003X
FLME84258207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
No207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL259477300Medicaid
FL5397458OtherAETNA
FL271651OtherAVMED
FL7260907001OtherCIGNA
FLME0084258OtherMEDICAL LICENSE
FL35864OtherBLUE CROSS BLUE SHIELD
FLME0084258OtherMEDICAL LICENSE
FL259477300Medicaid