Provider Demographics
NPI:1922174424
Name:GIGANTI, ANN WIDICK (ARNP)
Entity Type:Individual
Prefix:MS
First Name:ANN
Middle Name:WIDICK
Last Name:GIGANTI
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:605 MARK AND RANDY DR
Mailing Address - Street 2:
Mailing Address - City:SATELLITE BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32937-3928
Mailing Address - Country:US
Mailing Address - Phone:321-480-0960
Mailing Address - Fax:
Practice Address - Street 1:11600 S ORANGE BLOSSOM TRL
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32837-9215
Practice Address - Country:US
Practice Address - Phone:847-315-7980
Practice Address - Fax:484-450-2617
Is Sole Proprietor?:No
Enumeration Date:2006-11-27
Last Update Date:2018-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP1023552363LP0200X
FL1023552363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL008020800Medicaid