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General NPI Number Information
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NPI Number | 1174867899
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Entity Type | Organization
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Legal Business Name | ADVANCED DIGITAL ANATOMIC PATHOLOGY TECHNOLOGIES, PLLC
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Dates
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Enumeration Date | 11/19/2012
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Last Update Date | 02/13/2013
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Provider Practice Location Address
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Address Line | 27716 CASHFORD CIR STE 101C
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City | WESLEY CHAPEL
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State | FL
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Zip | 33544-6962
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Country | US
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Telephone | 813-669-9113
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Fax |
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Provider Business Mailing Address
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Address Line | 27716 CASHFORD CIR STE 101C
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City | WESLEY CHAPEL
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State | FL
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Zip | 33544-6962
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Country | US
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Telephone | 813-669-9113
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. DRAZEN M JUKIC
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Credential | M.D. PH. D.
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Telephone | 813-558-8170
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207ZP0101X
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Taxonomy Name | Anatomic Pathology Physician
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License Number |
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License Number State |
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