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General NPI Number Information
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NPI Number | 1255364378
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Entity Type | Individual
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Provider Name | JOHN N DIDOVIC MD
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Gender | Male
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Dates
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Enumeration Date | 07/09/2006
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Last Update Date | 03/09/2016
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Provider Practice Location Address
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Address Line | 4300 ALTON RD
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City | MIAMI BEACH
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State | FL
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Zip | 33140-2948
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Country | US
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Telephone | 305-674-2680
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Fax | 305-674-3919
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Provider Business Mailing Address
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Address Line | 720 LAKE RD
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City | MIAMI
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State | FL
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Zip | 33137-3331
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Country | US
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Telephone | 305-674-2680
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Fax | 305-674-3919
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0204X
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Taxonomy Name | Vascular & Interventional Radiology Physician
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License Number | ME72013
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | ME72013
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License Number State | FL
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