Provider Demographics
NPI:1073666095
Name:DRYGAS, JOHN CASIMIR (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:CASIMIR
Last Name:DRYGAS
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 1:900 CARILLON PKWY
Mailing Address - Street 2:SUITE 402A
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33716-1115
Mailing Address - Country:US
Mailing Address - Phone:727-480-5151
Mailing Address - Fax:
Practice Address - Street 1:900 CARILLON PKWY
Practice Address - Street 2:SUITE 402A
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33716-1115
Practice Address - Country:US
Practice Address - Phone:727-480-5151
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-21
Last Update Date:2015-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN46970207T00000X
FLME98127207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery