Provider Demographics
NPI:1255340493
Name:GIGLIO, PETER JOSEPH (DO)
Entity type:Individual
Prefix:DR
First Name:PETER
Middle Name:JOSEPH
Last Name:GIGLIO
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 1:7720 WASHINGTON ST STE 102
Mailing Address - Street 2:
Mailing Address - City:PORT RICHEY
Mailing Address - State:FL
Mailing Address - Zip Code:34668-6541
Mailing Address - Country:US
Mailing Address - Phone:727-842-5020
Mailing Address - Fax:727-847-7579
Practice Address - Street 1:7720 WASHINGTON ST STE 102
Practice Address - Street 2:
Practice Address - City:PORT RICHEY
Practice Address - State:FL
Practice Address - Zip Code:34668-6541
Practice Address - Country:US
Practice Address - Phone:727-842-5020
Practice Address - Fax:727-847-7579
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-05
Last Update Date:2008-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS4546207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLE34837Medicare UPIN
82565Medicare PIN