Provider Demographics
NPI:1265662886
Name:BERBIGLIA, LINDSAY (DO)
Entity Type:Individual
Prefix:
First Name:LINDSAY
Middle Name:
Last Name:BERBIGLIA
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2147
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33902-2147
Mailing Address - Country:US
Mailing Address - Phone:239-424-2755
Mailing Address - Fax:239-424-2756
Practice Address - Street 1:708 DEL PRADO BLVD S STE 6
Practice Address - Street 2:
Practice Address - City:CAPE CORAL
Practice Address - State:FL
Practice Address - Zip Code:33990
Practice Address - Country:US
Practice Address - Phone:239-424-2755
Practice Address - Fax:239-424-2756
Is Sole Proprietor?:No
Enumeration Date:2009-07-16
Last Update Date:2021-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS15930208600000X
OH34.011628208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL102749400Medicaid