Provider Demographics
NPI:1679100804
Name:HAGGERT, CASSANDRA CHRISTINE (DO)
Entity type:Individual
Prefix:
First Name:CASSANDRA
Middle Name:CHRISTINE
Last Name:HAGGERT
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10707 66TH ST N STE A
Mailing Address - Street 2:
Mailing Address - City:PINELLAS PARK
Mailing Address - State:FL
Mailing Address - Zip Code:33782-2353
Mailing Address - Country:US
Mailing Address - Phone:727-544-8300
Mailing Address - Fax:
Practice Address - Street 1:10707 66TH ST N STE A
Practice Address - Street 2:
Practice Address - City:PINELLAS PARK
Practice Address - State:FL
Practice Address - Zip Code:33782-2353
Practice Address - Country:US
Practice Address - Phone:727-544-8300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-26
Last Update Date:2023-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS19406207R00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine