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NPI Code Detail

MEDICARE: DR. VLADISLAV GORBATIY M.D.

MEDICARE: DR. VLADISLAV GORBATIY M.D.
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
1390200000XStudent in an Organized Health Care Education/Training ProgramTRN#14540FL
2208800000XUrology PhysicianME110963FL

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11P01099396OTHERFLRAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1P0005386OTHERFLFLORIDA HEALTHCARE PLUS
2P943414OTHERFLOPTIMUM
325877OTHERFLMEDICA
413088OTHERFLDIMENSIONS HEALTH
514LY8OTHERFLBCBS FL
63674924OTHERFLCIGNA
7MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
8813583OTHERFLWELLCARE
9P01727492OTHERFLSIMPLY HEALTHCARE
109916895OTHERFLAETNA
12QMP000004921476OTHERFLMOLINA
13F00349514201OTHERFLUNITED HEALTHCARE
14P1002957OTHERFLFREEDOM HEALTH
15MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1831414143
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. VLADISLAV GORBATIY M.D.
Provider Business Mailing Address
First Line : 2234 COLONIAL BLVD
Second Line : ATTN: PAYER CONTRACTING & RELATIONS
City : FORT MYERS
State : FL
Zip : 33907-1412
Country : US
Telephone Number : 239-931-7342
Fax Number : 239-931-7385
Provider Business Practice Location Address
First Line : 1200 E BROWARD BLVD
Second Line :
City : FORT LAUDERDALE
State : FL
Zip : 33301-2134
Country : US
Telephone Number : 954-463-6408
Fax Number : 954-463-1858
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/30/2010
Last Update Date : 03/31/2017

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