Provider Demographics
NPI:1720016199
Name:LEGASPI, BRIGIDO V (MD)
Entity Type:Individual
Prefix:
First Name:BRIGIDO
Middle Name:V
Last Name:LEGASPI
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 1:21150 BISCAYNE BLVD
Mailing Address - Street 2:SUITE 304
Mailing Address - City:AVENTURA
Mailing Address - State:FL
Mailing Address - Zip Code:33180-1226
Mailing Address - Country:US
Mailing Address - Phone:305-957-7664
Mailing Address - Fax:
Practice Address - Street 1:21150 BISCAYNE BLVD
Practice Address - Street 2:SUITE 304
Practice Address - City:AVENTURA
Practice Address - State:FL
Practice Address - Zip Code:33180-1226
Practice Address - Country:US
Practice Address - Phone:305-957-7664
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME72262207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLE2136Medicare ID - Type Unspecified
FLG87657Medicare UPIN