Healthcare Provider Details

I. General information

NPI: 1881834026
Provider Name (Legal Business Name): SUZANA BOGDANOVSKA D.O,
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/28/2009
Last Update Date: 12/02/2025
Certification Date: 12/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

222 S PENINSULA DR
DAYTONA BEACH FL
32118-4422
US

IV. Provider business mailing address

222 S PENINSULA DR
DAYTONA BEACH FL
32118-4422
US

V. Phone/Fax

Practice location:
  • Phone: 386-310-2160
  • Fax:
Mailing address:
  • Phone: 386-310-2160
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberOS11535
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberOS11535
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: