Individual
ANDREJ JIVITSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
700 DOCTORS CT, LEESBURG, FL 34748-7314
(352) 787-9838
(352) 787-8705
Mailing address
700 DOCTORS CT, LEESBURG, FL 34748-7314
(352) 867-8311
(352) 622-5771
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
036168506
IL
207L00000X
Anesthesiology Physician
C10006841
DE
207L00000X
Anesthesiology Physician
MD28379
ME
207L00000X
Anesthesiology Physician
Primary
ME119527
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
014042100
—
FL
01
—
14Z03
BCBS
FL
05
—
1841286408
—
ME
Enumeration date
09/20/2005
Last updated
11/22/2024
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