Provider Demographics
NPI:1710212998
Name:GIGLIO, MINDI D (DO)
Entity Type:Individual
Prefix:
First Name:MINDI
Middle Name:D
Last Name:GIGLIO
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:MINDI
Other - Middle Name:D
Other - Last Name:FISHER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:995 16TH ST N
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33705-1210
Mailing Address - Country:US
Mailing Address - Phone:727-894-4738
Mailing Address - Fax:727-823-6710
Practice Address - Street 1:995 16TH ST N
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33705-1210
Practice Address - Country:US
Practice Address - Phone:727-894-4738
Practice Address - Fax:727-823-6710
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-06
Last Update Date:2016-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS11487208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLHV509ZMedicare UPIN