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Individual

MITKO MITOV BADOV

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
9981 S HEALTHPARK DR, SUITE 159, FORT MYERS, FL 33908
(239) 343-2052
(239) 424-1421
Mailing address
P.O. BOX 2147, FORT MYERS, FL 33902-2147
(239) 343-2052
(239) 343-5348

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
ME 91488
FL
208M00000X
Hospitalist Physician
Primary
ME91488
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000820900
FL
05
2721431 00
FL
01
30021
BCBSFL
FL
Enumeration date
12/01/2005
Last updated
03/24/2021
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