Individual
DR. BRIAN J DEIGNAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3003 W DR MARTIN LUTHER KING JR BLVD, MAB-3RD FLOOR, TAMPA, FL 33607-6307
(813) 554-8983
(813) 443-8177
Mailing address
PO BOX 743409, ATLANTA, GA 30374-3409
(727) 532-0002
(727) 532-1325
Taxonomy
Speciality
Code
Description
License number
State
207XP3100X
Pediatric Orthopaedic Surgery Physician
Primary
ME115264
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0087555-00
—
FL
Enumeration date
06/29/2007
Last updated
12/10/2015
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