Organization Name: | VLADMIR J. VLCKO DO, P.A |
NPI Number: | 1154344125 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | PAM VLCKO (OFFICE MANAGER) |
Mailing Address: | 216 S Seminole Ave Inverness |
State: | FL US |
Postal Code: | 344524738 |
Phone Number: | 3525600333 |
Fax Number: | 3525600337 |
NPI Enumeration Date: | 07/25/2006 |
NPI Last Update Date: | 09/26/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |