Provider Demographics
NPI:1790022879
Name:TODOROV, VENTZISLAV TODOROV (RPH)
Entity Type:Individual
Prefix:DR
First Name:VENTZISLAV
Middle Name:TODOROV
Last Name:TODOROV
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6543 S TAMIAMI TRL
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34231-4827
Mailing Address - Country:US
Mailing Address - Phone:941-923-7735
Mailing Address - Fax:941-923-8195
Practice Address - Street 1:6543 S TAMIAMI TRL
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34231-4827
Practice Address - Country:US
Practice Address - Phone:941-923-7735
Practice Address - Fax:941-923-8195
Is Sole Proprietor?:No
Enumeration Date:2013-01-10
Last Update Date:2013-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS48126183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist