Provider Demographics
NPI:1417293648
Name:PIGUE, DAVID AARON
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:AARON
Last Name:PIGUE
Suffix:
Gender:M
Credentials:
Other - Prefix:MR
Other - First Name:AARON
Other - Middle Name:
Other - Last Name:PIGUE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMT
Mailing Address - Street 1:817 NW 15TH AVE
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32601-4039
Mailing Address - Country:US
Mailing Address - Phone:352-514-3233
Mailing Address - Fax:
Practice Address - Street 1:2441 NW 43RD ST STE 3A
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32606-7480
Practice Address - Country:US
Practice Address - Phone:352-378-8125
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-16
Last Update Date:2012-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL57218225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist