Provider Demographics
NPI:1487635470
Name:ADAMOV, DONALD JOHN (DPM)
Entity Type:Individual
Prefix:DR
First Name:DONALD
Middle Name:JOHN
Last Name:ADAMOV
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:15815 SHADDOCK DR STE 130
Mailing Address - Street 2:
Mailing Address - City:WINTER GARDEN
Mailing Address - State:FL
Mailing Address - Zip Code:34787-5773
Mailing Address - Country:US
Mailing Address - Phone:813-400-1140
Mailing Address - Fax:813-701-9132
Practice Address - Street 1:10441 QUALITY DR STE 103
Practice Address - Street 2:
Practice Address - City:SPRING HILL
Practice Address - State:FL
Practice Address - Zip Code:34609-9649
Practice Address - Country:US
Practice Address - Phone:352-606-3950
Practice Address - Fax:352-340-5947
Is Sole Proprietor?:No
Enumeration Date:2005-11-08
Last Update Date:2024-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO3518213E00000X, 213EP1101X, 213ES0131X, 213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
No213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
No213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric Medicine
No213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLP01515977OtherRR MEDICARE
FL7407580001OtherMEDICARE DME REGION A B C D
FL009196300Medicaid
FL6504JOtherBCBS
FL6504JOtherBCBS
FLP01515977OtherRR MEDICARE
INV05573Medicare UPIN