Provider Demographics
NPI:1568028397
Name:BILANOVIC, VOJISLAV
Entity Type:Individual
Prefix:
First Name:VOJISLAV
Middle Name:
Last Name:BILANOVIC
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6944 18TH ST N
Mailing Address - Street 2:
Mailing Address - City:SAINT PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33702-6550
Mailing Address - Country:US
Mailing Address - Phone:727-686-6479
Mailing Address - Fax:
Practice Address - Street 1:6944 18TH ST N
Practice Address - Street 2:
Practice Address - City:SAINT PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33702-6550
Practice Address - Country:US
Practice Address - Phone:727-686-6479
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-16
Last Update Date:2019-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental