Provider Demographics
NPI:1861841850
Name:STOJADINOVIC, OLIVERA (MD)
Entity Type:Individual
Prefix:
First Name:OLIVERA
Middle Name:
Last Name:STOJADINOVIC
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 1:1600 NW 10TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33136-1015
Mailing Address - Country:US
Mailing Address - Phone:305-243-6735
Mailing Address - Fax:
Practice Address - Street 1:1295 NW 14TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33125-1610
Practice Address - Country:US
Practice Address - Phone:305-243-6704
Practice Address - Fax:305-243-5303
Is Sole Proprietor?:No
Enumeration Date:2016-06-09
Last Update Date:2020-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME145650207N00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program