Individual
MR. VITALY BLATNOY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
7560 RED BUG LAKE RD STE 1014, OVIEDO, FL 32765-6591
(407) 706-1770
(407) 706-1777
Mailing address
7560 RED BUG LAKE RD STE 1014, OVIEDO, FL 32765-6591
(407) 706-1770
(407) 706-1777
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
ME92940
FL
2471S1302X
Sonography Radiologic Technologist
ME92940
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001633600
—
FL
Enumeration date
10/26/2005
Last updated
04/25/2024
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