Provider Demographics
NPI:1104122282
Name:NARODNI DOKTOR LLC
Entity type:Organization
Organization Name:NARODNI DOKTOR LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DEJAN
Authorized Official - Middle Name:H
Authorized Official - Last Name:DJOLIC
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:727-453-0583
Mailing Address - Street 1:7901 4TH ST N
Mailing Address - Street 2:SUITE 325
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33702-4305
Mailing Address - Country:US
Mailing Address - Phone:727-453-0583
Mailing Address - Fax:727-362-3649
Practice Address - Street 1:7901 4TH ST N
Practice Address - Street 2:SUITE 325
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33702-4305
Practice Address - Country:US
Practice Address - Phone:727-453-0583
Practice Address - Fax:727-362-3649
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-07
Last Update Date:2011-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty