Basic Information
| Provider Information | |||||||||
| NPI: | 1437590627 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | BOGDAN GOGIOIU MD PA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1032 SHORE ACRES DR | ||||||||
| Address2: | |||||||||
| City: | LEESBURG | ||||||||
| State: | FL | ||||||||
| PostalCode: | 347484506 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3527285466 | ||||||||
| FaxNumber: | 3527285466 | ||||||||
| Practice Location | |||||||||
| Address1: | 600 E DIXIE AVE | ||||||||
| Address2: | |||||||||
| City: | LEESBURG | ||||||||
| State: | FL | ||||||||
| PostalCode: | 347485925 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3527285466 | ||||||||
| FaxNumber: | 3527285466 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/16/2013 | ||||||||
| LastUpdateDate: | 07/16/2013 | ||||||||
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| AuthorizedOfficialLastName: | GOGIOIU | ||||||||
| AuthorizedOfficialFirstName: | BOGDAN | ||||||||
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| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 3527285466 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | M D | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | ME87859 | FL | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.