MEDICARE: VLADIMIR J DINOLOV 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
1	207Q00000X	Family Medicine Physician	ME40321	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	17533	OTHER	FL	BCBS FL

General Provider Information

NPI Number	:	1942269428
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VLADIMIR J DINOLOV MD

Provider Business Mailing Address
First Line	:	2343 AARON ST
Second Line	:
City	:	PORT CHARLOTTE
State	:	FL
Zip	:	33952-5305
Country	:	US
Telephone Number	:	941-629-2900
Fax Number	:	941-629-6143

Provider Business Practice Location Address
First Line	:	2343 AARON ST
Second Line	:
City	:	PORT CHARLOTTE
State	:	FL
Zip	:	33952-5305
Country	:	US
Telephone Number	:	941-629-2900
Fax Number	:	941-629-6143

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/22/2006
Last Update Date	:	10/14/2008

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