Provider Demographics
NPI:1265417695
Name:DIGIORGIO, MICHAEL (MD)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:
Last Name:DIGIORGIO
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:PO BOX 223293
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15251-2293
Mailing Address - Country:US
Mailing Address - Phone:844-699-0003
Mailing Address - Fax:855-812-4913
Practice Address - Street 1:1801 S PERIMETER RD
Practice Address - Street 2:SUITE 180
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33309-7139
Practice Address - Country:US
Practice Address - Phone:954-839-8080
Practice Address - Fax:954-839-8081
Is Sole Proprietor?:No
Enumeration Date:2005-12-08
Last Update Date:2016-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME870792085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL18439OtherBC BS
FL266419400Medicaid
FL300138269OtherRAILROAD MEDICARE
FLF48915Medicare UPIN
FL266419400Medicaid