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General NPI Number Information
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NPI Number | 1376879361
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Entity Type | Organization
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Legal Business Name | INFECTIOUS DISEASES OF THE TREASURE COAST PA
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Dates
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Enumeration Date | 10/26/2009
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Last Update Date | 10/26/2009
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Provider Practice Location Address
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Address Line | 501 NW LAKE WHITNEY PL SUITE 102
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City | PORT ST LUCIE
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State | FL
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Zip | 34986-1615
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Country | US
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Telephone | 772-343-1570
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Fax | 772-343-1601
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Provider Business Mailing Address
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Address Line | 501 NW LAKE WHITNEY PL SUITE 102
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City | PORT ST LUCIE
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State | FL
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Zip | 34986-1615
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Country | US
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Telephone | 772-343-1570
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Fax | 772-343-1601
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. DRAGANA ORLOVIC
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Credential | MD
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Telephone | 772-343-1570
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RI0200X
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Taxonomy Name | Infectious Disease Physician
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License Number | ME 92636
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License Number State | FL
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