Provider Demographics
NPI:1225057193
Name:DIZON, ALEJANDRO CABIGTING (MD)
Entity Type:Individual
Prefix:
First Name:ALEJANDRO
Middle Name:CABIGTING
Last Name:DIZON
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 1:9860 BEACH BLVD
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32246-4704
Mailing Address - Country:US
Mailing Address - Phone:904-807-9112
Mailing Address - Fax:904-807-9114
Practice Address - Street 1:9860 BEACH BLVD
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32246-4704
Practice Address - Country:US
Practice Address - Phone:904-807-9112
Practice Address - Fax:904-807-9114
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-19
Last Update Date:2024-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME88405207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL272420100Medicaid
FL272420100Medicaid
FLG81071Medicare UPIN