Provider Demographics
NPI:1003895491
Name:RIGGALL, FRANK CORSON (MD)
Entity Type:Individual
Prefix:DR
First Name:FRANK
Middle Name:CORSON
Last Name:RIGGALL
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 1:2501 N ORANGE AVE
Mailing Address - Street 2:SUITE 209
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32804-4603
Mailing Address - Country:US
Mailing Address - Phone:407-898-0254
Mailing Address - Fax:407-898-6224
Practice Address - Street 1:2501 N ORANGE AVE
Practice Address - Street 2:SUITE 209
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32804-4603
Practice Address - Country:US
Practice Address - Phone:407-898-0254
Practice Address - Fax:407-898-6224
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-13
Last Update Date:2010-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME19309174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLD82539Medicare UPIN
FL71869Medicare ID - Type Unspecified