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NPI Code Detail

MEDICARE: ILANA KRISTINA LOGVINSKY MD

MEDICARE: ILANA KRISTINA LOGVINSKY MD
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
1207R00000XInternal Medicine PhysicianME175315FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1558063685
Entity Type Code : Individual
Provider Name (Legal Business Name) : ILANA KRISTINA LOGVINSKY MD
Provider Business Mailing Address
First Line : PO BOX 2147
Second Line :
City : FORT MYERS
State : FL
Zip : 33902-2147
Country : US
Telephone Number : 239-424-1900
Fax Number : 239-424-1908
Provider Business Practice Location Address
First Line : 224 SANTA BARBARA BLVD STE 102
Second Line :
City : CAPE CORAL
State : FL
Zip : 33991-2038
Country : US
Telephone Number : 239-424-1900
Fax Number : 239-424-1908
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/21/2023
Last Update Date : 12/10/2025

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Directions to “ ILANA KRISTINA LOGVINSKY MD” Practice Location

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