Provider Demographics
NPI:1891090528
Name:DIGIOVANNI, ERNEST (DO)
Entity Type:Individual
Prefix:
First Name:ERNEST
Middle Name:
Last Name:DIGIOVANNI
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10820 STATE ROAD 54 STE 201
Mailing Address - Street 2:
Mailing Address - City:NEW PORT RICHEY
Mailing Address - State:FL
Mailing Address - Zip Code:34655-2291
Mailing Address - Country:US
Mailing Address - Phone:727-846-7031
Mailing Address - Fax:727-846-7132
Practice Address - Street 1:10820 STATE ROAD 54 STE 201
Practice Address - Street 2:
Practice Address - City:NEW PORT RICHEY
Practice Address - State:FL
Practice Address - Zip Code:34655-2291
Practice Address - Country:US
Practice Address - Phone:727-846-7031
Practice Address - Fax:727-846-7132
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-11
Last Update Date:2019-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLO11506208M00000X
FLOS11506207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Multi-Specialty
No208M00000XAllopathic & Osteopathic PhysiciansHospitalistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL016286900Medicaid
FLPENDINGOtherMEDICARE