Provider Demographics
NPI:1023248705
Name:DONCHEV, VLADIMIR BOGOMILOV (MD)
Entity type:Individual
Prefix:DR
First Name:VLADIMIR
Middle Name:BOGOMILOV
Last Name:DONCHEV
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 1:9901 BRICKHILL DR
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33428-3007
Mailing Address - Country:US
Mailing Address - Phone:917-282-9241
Mailing Address - Fax:
Practice Address - Street 1:7421 N UNIVERSITY DR STE 107
Practice Address - Street 2:
Practice Address - City:TAMARAC
Practice Address - State:FL
Practice Address - Zip Code:33321-2952
Practice Address - Country:US
Practice Address - Phone:954-726-0095
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-07-16
Last Update Date:2022-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAMD-42338208600000X
FLME142478208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL104472300Medicaid