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NPI Code Detail

MEDICARE: BOGDANOVSKI, PLLC

MEDICARE: BOGDANOVSKI, PLLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine PhysicianOS11535FL

General Provider Information

NPI Number : 1235550419
Entity Type Code : Organization
Provider Name (Legal Business Name) : BOGDANOVSKI, PLLC
Provider Business Mailing Address
First Line : 909 STERTHAUS DR
Second Line :
City : ORMOND BEACH
State : FL
Zip : 32174-5133
Country : US
Telephone Number : 386-673-1717
Fax Number : 386-672-7819
Provider Business Practice Location Address
First Line : 909 STERTHAUS DR
Second Line :
City : ORMOND BEACH
State : FL
Zip : 32174-5133
Country : US
Telephone Number : 386-673-1717
Fax Number : 386-672-7819
Authorized Official
Title or Position : MANAGER
Name : DR. SUZANA BOGDANOVSKA
Credential : DO
Telephone Number : 386-673-1717
Provider Enumeration Date : 12/14/2013
Last Update Date : 12/14/2013

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Directions to “BOGDANOVSKI, PLLC ” Practice Location

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