Individual
SRDJAN PRODANOVICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
90 CYPRESS WAY E, SUITE 50, NAPLES, FL 34110-9275
(239) 598-3200
(239) 598-0233
Mailing address
90 CYPRESS WAY E, SUITE 50, NAPLES, FL 34110-9275
(239) 598-3200
(239) 598-0233
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
ME95851
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
276398200
—
FL
01
—
53224
BCBS
FL
01
—
7613852
AETNA
—
01
—
P00423914
MEDICARE RAILROAD
FL
Enumeration date
05/28/2006
Last updated
01/23/2014
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