Roberta Marie Killeen, MD

Primary specialty

Anatomic Pathology PhysicianTaxonomy code 207ZP0101X

License

ME58665 Issued in FL

Practice address

2520 US Highway 19
Holiday, FL 34691-3846

Phone

(727) 934-6905

Fax

(727) 934-4045

NPI assigned

Aug 16, 2005

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Roberta M Killeen MD PA

  • Clinical Medical Laboratory
  • Holiday, FL
  • NPI 1609039361

  Anatomic Pathology

  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1124150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1316390400000",
    "number": "1245222447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2520 US HIGHWAY 19",
            "city": "HOLIDAY",
            "state": "FL",
            "postal_code": "346913846",
            "telephone_number": "727-934-6905",
            "fax_number": "727-934-4045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2520 US HIGHWAY 19",
            "city": "HOLIDAY",
            "state": "FL",
            "postal_code": "346913846",
            "telephone_number": "727-934-6905",
            "fax_number": "727-934-4045"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KILLEEN",
        "first_name": "ROBERTA",
        "middle_name": "MARIE",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-08-16",
        "last_updated": "2011-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0101X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology",
            "state": "FL",
            "license": "ME58665",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "052961300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Debra Kalodoukas, M.S.C. CCC-SLP
• Isam Kazaleh
• Cathy R. Kessenich, ARNP
• Anuja Khadka, LCSW
• Robert Bruce Killeen Jr., MD
• Midori Kimura, LCSW
• Alexandra Kolioradakis, MS, CCC-SLP
• Vicki Kunkel
• Aleesa Lafleur
• Anthony Lane, PHARMACIST

• Anatomic Pathology Physician in Holiday, FL
• Providers in Holiday, FL by specialty
• Anatomic Pathology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.