Provider Demographics
NPI:1275589764
Name:MILOVANOVIC, ALEKSANDAR (MD)
Entity Type:Individual
Prefix:
First Name:ALEKSANDAR
Middle Name:
Last Name:MILOVANOVIC
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 8311
Mailing Address - Street 2:
Mailing Address - City:JUPITER
Mailing Address - State:FL
Mailing Address - Zip Code:33468-8311
Mailing Address - Country:US
Mailing Address - Phone:561-660-1642
Mailing Address - Fax:855-346-3285
Practice Address - Street 1:210 JUPITER LAKES BLVD STE 4202
Practice Address - Street 2:
Practice Address - City:JUPITER
Practice Address - State:FL
Practice Address - Zip Code:33458-7190
Practice Address - Country:US
Practice Address - Phone:561-660-1642
Practice Address - Fax:855-346-3285
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-26
Last Update Date:2024-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME131026207RN0300X, 207R00000X, 207RN0300X
MI4301086965207RN0300X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Single Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1275589764OtherNPI #
MI70-0-F32947-0OtherBCBS CPIN #
MI5183262-10Medicaid
MI5183262-10Medicaid
MIP28070100Medicare PIN