Provider Demographics
NPI:1255547428
Name:NORTHERN MEDICAL CENTER PC
Entity type:Organization
Organization Name:NORTHERN MEDICAL CENTER PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DORIT
Authorized Official - Middle Name:
Authorized Official - Last Name:YABROV
Authorized Official - Suffix:
Authorized Official - Credentials:MD,
Authorized Official - Phone:941-423-0800
Mailing Address - Street 1:PO BOX 7485
Mailing Address - Street 2:
Mailing Address - City:NORTH PORT
Mailing Address - State:FL
Mailing Address - Zip Code:34287-0000
Mailing Address - Country:US
Mailing Address - Phone:941-423-0800
Mailing Address - Fax:941-423-0232
Practice Address - Street 1:5400 S BISCAYNE DR
Practice Address - Street 2:
Practice Address - City:NORTH PORT
Practice Address - State:FL
Practice Address - Zip Code:34287-1932
Practice Address - Country:US
Practice Address - Phone:941-423-0800
Practice Address - Fax:941-423-0232
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME93717207QG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric MedicineGroup - Multi-Specialty