Provider Demographics
NPI:1265424378
Name:PIERPONT, BRIEN E (MD)
Entity type:Individual
Prefix:DR
First Name:BRIEN
Middle Name:E
Last Name:PIERPONT
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 1:2299 9TH AVE N
Mailing Address - Street 2:SUITE 3-C
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33713-6800
Mailing Address - Country:US
Mailing Address - Phone:727-321-7721
Mailing Address - Fax:727-321-6924
Practice Address - Street 1:2299 9TH AVE N
Practice Address - Street 2:SUITE 3-C
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33713-6800
Practice Address - Country:US
Practice Address - Phone:727-321-7721
Practice Address - Fax:727-321-6924
Is Sole Proprietor?:No
Enumeration Date:2005-08-16
Last Update Date:2013-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0040624174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL046164400Medicaid
FL046164400Medicaid
FLD21853Medicare UPIN