Provider Demographics
NPI:1184059503
Name:ENMAN, SVETLANA (DO)
Entity type:Individual
Prefix:DR
First Name:SVETLANA
Middle Name:
Last Name:ENMAN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 10744
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33757-8744
Mailing Address - Country:US
Mailing Address - Phone:727-532-0002
Mailing Address - Fax:727-266-4943
Practice Address - Street 1:400 PINELLAS ST
Practice Address - Street 2:SUITE 350
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33756-3312
Practice Address - Country:US
Practice Address - Phone:727-462-3696
Practice Address - Fax:813-635-2656
Is Sole Proprietor?:No
Enumeration Date:2013-09-04
Last Update Date:2016-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLUO3072207R00000X
FLOS13157207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLP01606383OtherRAILROAD MEDICARE PROVIDER NUMBER