Individual
DR. DIMITRI NOVITZKY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1001 N MACDILL AVE STE B, TAMPA, FL 33607
(813) 675-4849
Mailing address
4407 VIEUX CARRE CIR, TAMPA, FL 33613-3052
(813) 390-5344
(386) 774-1264
Taxonomy
Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
Primary
ME61367
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
064781100
—
FL
01
—
11642
BLUE CROSS BLUE SHIELD
FL
01
—
1215972526
MEDICARE NPI
—
Enumeration date
06/19/2006
Last updated
05/27/2019
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