Healthcare Provider Details
I. General information
NPI: 1487635470
Provider Name (Legal Business Name): DONALD JOHN ADAMOV D.P.M.
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 11/08/2005
Last Update Date: 03/10/2025
Certification Date: 03/10/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
10441 QUALITY DR STE 103
SPRING HILL FL
34609-9649
US
IV. Provider business mailing address
15815 SHADDOCK DR STE 130
WINTER GARDEN FL
34787-5773
US
V. Phone/Fax
- Phone: 352-606-3950
- Fax: 352-340-5947
- Phone: 813-400-1140
- Fax: 813-701-9132
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 213EP1101X |
| Taxonomy | Primary Podiatric Medicine Podiatrist |
| License Number | PO3518 |
| License Number State | FL |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 213ES0103X |
| Taxonomy | Foot & Ankle Surgery Podiatrist |
| License Number | PO3518 |
| License Number State | FL |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 213ES0131X |
| Taxonomy | Foot Surgery Podiatrist |
| License Number | PO3518 |
| License Number State | FL |
| # 4 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 213E00000X |
| Taxonomy | Podiatrist |
| License Number | PO3518 |
| License Number State | FL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: