Provider Demographics
NPI:1720070295
Name:FILIAGGI, KATHLEEN L (MD)
Entity type:Individual
Prefix:DR
First Name:KATHLEEN
Middle Name:L
Last Name:FILIAGGI
Suffix:
Gender:F
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:PO BOX 100707 SUITE 700
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30384-0001
Mailing Address - Country:US
Mailing Address - Phone:786-594-6880
Mailing Address - Fax:
Practice Address - Street 1:5701 OVERSEAS HWY STE 17
Practice Address - Street 2:
Practice Address - City:MARATHON
Practice Address - State:FL
Practice Address - Zip Code:33050-2784
Practice Address - Country:US
Practice Address - Phone:305-434-1400
Practice Address - Fax:305-743-0962
Is Sole Proprietor?:No
Enumeration Date:2005-08-19
Last Update Date:2023-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD427213207R00000X
FLME92454207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1013641460001Medicaid
PA1760685OtherHIGHMARK BC/BS
PA094522Medicare PIN
PA1760685OtherHIGHMARK BC/BS