Healthcare Provider Details
I. General information
NPI: 1982641494
Provider Name (Legal Business Name): SLOBODAN JAZAREVIC M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 06/01/2006
Last Update Date: 03/08/2024
Certification Date: 03/08/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1720 SE 16TH AVE STE 303
OCALA FL
34471-4620
US
IV. Provider business mailing address
1720 SE 16TH AVE STE 303
OCALA FL
34471-4620
US
V. Phone/Fax
- Phone: 352-369-0288
- Fax:
- Phone: 352-369-0288
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2086S0102X |
| Taxonomy | Surgical Critical Care Physician |
| License Number | ME65570 |
| License Number State | FL |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208600000X |
| Taxonomy | Surgery Physician |
| License Number | ME65570 |
| License Number State | FL |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208600000X |
| Taxonomy | Surgery Physician |
| License Number | 192322-1 |
| License Number State | NY |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2086S0102X |
| Taxonomy | Surgical Critical Care Physician |
| License Number | DR00552407 |
| License Number State | CO |
| # 5 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2086S0102X |
| Taxonomy | Surgical Critical Care Physician |
| License Number | 192322-1 |
| License Number State | NY |
| # 6 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2086S0129X |
| Taxonomy | Vascular Surgery Physician |
| License Number | ME65570 |
| License Number State | FL |
| # 7 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2086S0129X |
| Taxonomy | Vascular Surgery Physician |
| License Number | 192322-1 |
| License Number State | NY |
| # 8 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2086S0127X |
| Taxonomy | Trauma Surgery Physician |
| License Number | DR0052407 |
| License Number State | CO |
| # 9 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208600000X |
| Taxonomy | Surgery Physician |
| License Number | DR0052407 |
| License Number State | CO |
| # 10 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208600000X |
| Taxonomy | Surgery Physician |
| License Number | 192322 |
| License Number State | NY |
| # 11 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2086S0120X |
| Taxonomy | Pediatric Surgery Physician |
| License Number | 192322 |
| License Number State | NY |
| # 12 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2086S0127X |
| Taxonomy | Trauma Surgery Physician |
| License Number | ME65570 |
| License Number State | FL |
| # 13 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2086S0127X |
| Taxonomy | Trauma Surgery Physician |
| License Number | 192322-1 |
| License Number State | NY |
| # 14 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2086S0127X |
| Taxonomy | Trauma Surgery Physician |
| License Number | 192322 |
| License Number State | NY |
| # 15 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2086S0129X |
| Taxonomy | Vascular Surgery Physician |
| License Number | DR0052407 |
| License Number State | CO |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone:
