Provider Demographics
NPI:1376180604
Name:DJURIC, VLADIMIR (DC)
Entity Type:Individual
Prefix:DR
First Name:VLADIMIR
Middle Name:
Last Name:DJURIC
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12960 LILLIAN HWY
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32506-8423
Mailing Address - Country:US
Mailing Address - Phone:850-741-4389
Mailing Address - Fax:
Practice Address - Street 1:12960 LILLIAN HWY
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32506-8423
Practice Address - Country:US
Practice Address - Phone:850-741-4389
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-12-05
Last Update Date:2020-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH12889111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor