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General NPI Number Information
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NPI Number | 1679881809
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Entity Type | Individual
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Provider Name | VLADIMIR VLADIMIROVICH SENATOROV SR. M.D., PH.D.
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Gender | Male
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Dates
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Enumeration Date | 09/22/2010
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Last Update Date | 02/28/2025
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Provider Practice Location Address
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Address Line | 950 COUNTY ROAD 17A W
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City | AVON PARK
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State | FL
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Zip | 33825-2164
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Country | US
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Telephone | 866-234-8534
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Fax | 863-452-3001
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Provider Business Mailing Address
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Address Line | 47 5TH ST NW
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City | WINTER HAVEN
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State | FL
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Zip | 33881-4672
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Country | US
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Telephone | 863-452-3012
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Fax | 863-291-5124
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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 | 2083P0901X
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Taxonomy Name | Public Health & General Preventive Medicine Physician
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License Number | ME123567
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | ME123567
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | ME123567
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License Number State | FL
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