Healthcare Provider Details

I. General information

NPI: 1093641557
Provider Name (Legal Business Name): MARKO BOJKOVIC BOJKOVIC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/22/2026
Last Update Date: 06/22/2026
Certification Date: 06/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7315 BAYOU CLUB BLVD N
PINELLAS PARK FL
33782-4331
US

IV. Provider business mailing address

7315 BAYOU CLUB BLVD N
PINELLAS PARK FL
33782-4331
US

V. Phone/Fax

Practice location:
  • Phone: 727-470-3799
  • Fax:
Mailing address:
  • Phone: 727-470-3799
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246ZE0600X
TaxonomyElectroneurodiagnostic Specialist/Technologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: