Provider Demographics
NPI:1124382544
Name:FERRIGON, LENIESHA (MD)
Entity Type:Individual
Prefix:
First Name:LENIESHA
Middle Name:
Last Name:FERRIGON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 GOODLETTE RD N
Mailing Address - Street 2:#310
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34102-5400
Mailing Address - Country:US
Mailing Address - Phone:239-624-0870
Mailing Address - Fax:239-261-6304
Practice Address - Street 1:800 GOODLETTE RD N
Practice Address - Street 2:#310
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34102-5400
Practice Address - Country:US
Practice Address - Phone:239-624-0870
Practice Address - Fax:239-624-0881
Is Sole Proprietor?:No
Enumeration Date:2012-06-29
Last Update Date:2020-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME124082207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL015118800Medicaid
FL150HDOtherBCBS
FLIF413ZOtherMEDICARE
FLIF413ZOtherMEDICARE