Provider Demographics
NPI:1518088061
Name:STOYANOV, VESELIN S (MD)
Entity Type:Individual
Prefix:
First Name:VESELIN
Middle Name:S
Last Name:STOYANOV
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 1:4627 RUE BORDEAUX
Mailing Address - Street 2:
Mailing Address - City:LUTZ
Mailing Address - State:FL
Mailing Address - Zip Code:33558-5365
Mailing Address - Country:US
Mailing Address - Phone:813-749-6006
Mailing Address - Fax:727-372-1009
Practice Address - Street 1:5500 LITTLE RD
Practice Address - Street 2:
Practice Address - City:NEW PORT RICHEY
Practice Address - State:FL
Practice Address - Zip Code:34655-1105
Practice Address - Country:US
Practice Address - Phone:727-372-1005
Practice Address - Fax:727-801-7081
Is Sole Proprietor?:No
Enumeration Date:2007-04-03
Last Update Date:2023-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME98240207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL95142OtherBCBS
FLK5888OtherMEDICARE GROUP PIN
FL279669400Medicaid
FLP01036787OtherRAILROAD MEDICARE ATTACHED TO GRP# DR6927
FLK2539OtherMEDICARE GROUP PIN