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General NPI Number Information
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NPI Number | 1376881961
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Entity Type | Organization
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Legal Business Name | DIMITER B HRISTOV, M.D.,P.A.
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Dates
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Enumeration Date | 01/17/2013
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Last Update Date | 04/12/2013
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Provider Practice Location Address
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Address Line | 1030 BIMINI LN
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City | RIVIERA BEACH
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State | FL
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Zip | 33404-2704
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Country | US
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Telephone | 561-799-9559
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Fax | 561-799-9577
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Provider Business Mailing Address
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Address Line | 1030 BIMINI LN
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City | RIVIERA BEACH
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State | FL
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Zip | 33404-2704
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Country | US
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Telephone | 561-799-9559
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Fax | 561-799-9577
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Authorized Official
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Title or Position | OWNER
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Name | DR. DIMITER HRISTOV
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Credential | M.D.
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Telephone | 561-799-9559
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number |
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License Number State |
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