Individual
DR. ADAM DIMITROV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
13000 SAWGRASS VILLAGE CIR STE 46, PONTE VEDRA BEACH, FL 32082-5023
(904) 202-6348
(904) 376-3019
Mailing address
PO BOX 45443, SALT LAKE CITY, UT 84145-0443
(904) 202-1032
(904) 376-4107
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
ME102216
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0008301-00
—
FL
01
—
P00710723
RR MEDICARE
FL
Enumeration date
03/14/2006
Last updated
11/22/2024
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