Provider Demographics
NPI:1427029586
Name:BRIGGS, BRIAN T (MD)
Entity Type:Individual
Prefix:
First Name:BRIAN
Middle Name:T
Last Name:BRIGGS
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 1:836 SUNSET LAKE BLVD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:VENICE
Mailing Address - State:FL
Mailing Address - Zip Code:34292-7555
Mailing Address - Country:US
Mailing Address - Phone:941-497-1771
Mailing Address - Fax:941-497-1860
Practice Address - Street 1:836 SUNSET LAKE BLVD
Practice Address - Street 2:SUITE 102
Practice Address - City:VENICE
Practice Address - State:FL
Practice Address - Zip Code:34292-7555
Practice Address - Country:US
Practice Address - Phone:941-497-1771
Practice Address - Fax:941-497-1860
Is Sole Proprietor?:No
Enumeration Date:2006-01-27
Last Update Date:2008-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND4223207X00000X
MN22042207X00000X
FLME100834207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND13191Medicaid
200033875OtherRR MEDICARE
MN38M70BROtherBLUE CROSS-MN
ND016001OtherBCBS ND
FL45975OtherBCBS - FL
MN662097300Medicaid
FL76184OtherBCBS - FL
5613280001OtherADMINISTAR
FL76184OtherBCBS - FL
200033875OtherRR MEDICARE
ND13191Medicaid
FLAR989ZMedicare PIN
FLK2847Medicare PIN