Provider Demographics
NPI:1154344125
Name:VLADMIR J. VLCKO DO, P.A
Entity type:Organization
Organization Name:VLADMIR J. VLCKO DO, P.A
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:PAM
Authorized Official - Middle Name:
Authorized Official - Last Name:VLCKO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:352-560-0333
Mailing Address - Street 1:216 S SEMINOLE AVE
Mailing Address - Street 2:
Mailing Address - City:INVERNESS
Mailing Address - State:FL
Mailing Address - Zip Code:34452-4738
Mailing Address - Country:US
Mailing Address - Phone:352-560-0333
Mailing Address - Fax:352-560-0337
Practice Address - Street 1:216 S SEMINOLE AVE
Practice Address - Street 2:
Practice Address - City:INVERNESS
Practice Address - State:FL
Practice Address - Zip Code:34452-4738
Practice Address - Country:US
Practice Address - Phone:352-560-0333
Practice Address - Fax:352-560-0337
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-25
Last Update Date:2020-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty