Provider Demographics
NPI:1730160607
Name:BIGGS, PAUL R (MD)
Entity type:Individual
Prefix:
First Name:PAUL
Middle Name:R
Last Name:BIGGS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:65 EAST NASA BLVD.
Mailing Address - Street 2:SUITE 202
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32901
Mailing Address - Country:US
Mailing Address - Phone:321-733-0663
Mailing Address - Fax:321-409-1786
Practice Address - Street 1:1223 GATEWAY DRIVE
Practice Address - Street 2:
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32901-2607
Practice Address - Country:US
Practice Address - Phone:321-725-4500
Practice Address - Fax:321-409-1786
Is Sole Proprietor?:No
Enumeration Date:2005-11-08
Last Update Date:2009-10-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME41416207QG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL9908451OtherCIGNA
FL080104964OtherRAILROAD MEDICARE
FL0809703OtherAETNA
FL378230100Medicaid
FL26867OtherBLUE CROSS BLUE SHIELD
FL5146027OtherAETNA
FL080104964OtherRAILROAD MEDICARE
FL0809703OtherAETNA