Provider Demographics
NPI:1265480891
Name:ATANASOSKI MCCORMACK, VIOLETA (MD)
Entity Type:Individual
Prefix:
First Name:VIOLETA
Middle Name:
Last Name:ATANASOSKI MCCORMACK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:VIOLETA
Other - Middle Name:
Other - Last Name:ATANASOSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1700 NW 49TH ST STE 125
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33309-3750
Mailing Address - Country:US
Mailing Address - Phone:954-355-4665
Mailing Address - Fax:954-355-4881
Practice Address - Street 1:1625 SE 3RD AVE STE 300
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33316-2521
Practice Address - Country:US
Practice Address - Phone:954-355-4665
Practice Address - Fax:954-355-4881
Is Sole Proprietor?:No
Enumeration Date:2006-05-05
Last Update Date:2024-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME54176207R00000X, 207RC0000X, 207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLP00198045OtherRR MEDICARE
FL061104200Medicaid
FL08782OtherBCBS
FL08782OtherBCBS
FL08782TMedicare PIN