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NPI Code Detail

MEDICARE: DRAGI BOGDANOVSKI D.O.

MEDICARE: DRAGI BOGDANOVSKI D.O.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician0S11536FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1461074492OTHERFLFAMILY PRACTICE

General Provider Information

NPI Number : 1144462102
Entity Type Code : Individual
Provider Name (Legal Business Name) : DRAGI BOGDANOVSKI D.O.
Provider Business Mailing Address
First Line : 909 STERTHAUS DR
Second Line :
City : ORMOND BEACH
State : FL
Zip : 32174-5133
Country : US
Telephone Number : 386-673-1717
Fax Number : 386-677-0463
Provider Business Practice Location Address
First Line : 909 STERTHAUS DR
Second Line :
City : ORMOND BEACH
State : FL
Zip : 32174-5133
Country : US
Telephone Number : 386-673-1717
Fax Number : 386-672-7879
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/06/2009
Last Update Date : 09/20/2018

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