Basic Information
| Provider Information | |||||||||
| NPI: | 1518271436 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | KAROVSKA VUCHIDOLOV | ||||||||
| FirstName: | ANA | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 33049 PROFESSIONAL DR | ||||||||
| Address2: | STE 103 | ||||||||
| City: | LEESBURG | ||||||||
| State: | FL | ||||||||
| PostalCode: | 347883705 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3522592159 | ||||||||
| FaxNumber: | 3522595731 | ||||||||
| Practice Location | |||||||||
| Address1: | 33049 PROFESSIONAL DR | ||||||||
| Address2: | STE 103 | ||||||||
| City: | LEESBURG | ||||||||
| State: | FL | ||||||||
| PostalCode: | 347883705 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3523651224 | ||||||||
| FaxNumber: | 3523651224 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/03/2010 | ||||||||
| LastUpdateDate: | 05/20/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 05/20/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | ME116096 | FL | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
ID Information
| ID | Type | State | Issuer | Description | 103480600 | 05 | FL | MEDICAID |