Individual
NIKOLAY ANTONOV GOSPODINOV
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RMA
Contact information
Practice address
5520 W CHANDLER BLVD STE 3, CHANDLER, AZ 85226-3693
(602) 362-3974
Mailing address
21021 N 56TH ST APT 3091, PHOENIX, AZ 85054-5609
(602) 377-1064
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
3041275
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3041275
RMA LICENSE
AZ
Enumeration date
04/01/2025
Last updated
04/11/2025
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