Provider Demographics
NPI:1649509746
Name:FLORENCE DAVIDOVSKI, M. D.,P.A.
Entity type:Organization
Organization Name:FLORENCE DAVIDOVSKI, M. D.,P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:FLORENCE
Authorized Official - Middle Name:
Authorized Official - Last Name:DAVIDOVSKI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:410-646-5353
Mailing Address - Street 1:3449 WILKENS AVE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21229-5281
Mailing Address - Country:US
Mailing Address - Phone:410-646-5869
Mailing Address - Fax:410-646-5869
Practice Address - Street 1:3449 WILKENS AVE
Practice Address - Street 2:SUITE 101
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21229-5281
Practice Address - Country:US
Practice Address - Phone:410-646-5869
Practice Address - Fax:410-646-5869
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-18
Last Update Date:2009-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0033449174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD549791400Medicaid
MD2590Medicare PIN