Healthcare Provider Details

I. General information

NPI: 1801086426
Provider Name (Legal Business Name): JORDAN DIMITROV SAVOV M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/30/2007
Last Update Date: 11/06/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1629 NORTHGATE DR
NAPLES FL
34105-2183
US

IV. Provider business mailing address

1629 NORTHGATE DR
NAPLES FL
34105-2183
US

V. Phone/Fax

Practice location:
  • Phone: 239-430-0845
  • Fax: 888-934-2737
Mailing address:
  • Phone: 239-430-0845
  • Fax: 888-934-2737

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberME99799
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberME99799
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code207QH0002X
TaxonomyHospice and Palliative Medicine (Family Medicine) Physician
License NumberME99799
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: