Provider Demographics
NPI:1699859496
Name:BJEKIC, GORDANA (MD)
Entity Type:Individual
Prefix:
First Name:GORDANA
Middle Name:
Last Name:BJEKIC
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21355 E DIXIE HWY
Mailing Address - Street 2:STE 102
Mailing Address - City:AVENTURA
Mailing Address - State:FL
Mailing Address - Zip Code:33180-1239
Mailing Address - Country:US
Mailing Address - Phone:305-932-2552
Mailing Address - Fax:
Practice Address - Street 1:21355 E DIXIE HWY
Practice Address - Street 2:STE 102
Practice Address - City:AVENTURA
Practice Address - State:FL
Practice Address - Zip Code:33180-1239
Practice Address - Country:US
Practice Address - Phone:305-932-2552
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-25
Last Update Date:2016-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 71407207RC0200X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLHY503YMedicare PIN
G45097Medicare UPIN
CA00A796120Medicaid